Provider Demographics
NPI:1790025138
Name:LEXICON THERAPY, INC.
Entity Type:Organization
Organization Name:LEXICON THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:321-363-6675
Mailing Address - Street 1:648 BLUEBIRD CT
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3927
Mailing Address - Country:US
Mailing Address - Phone:321-363-6675
Mailing Address - Fax:
Practice Address - Street 1:648 BLUEBIRD CT
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3927
Practice Address - Country:US
Practice Address - Phone:321-363-6675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty