Provider Demographics
NPI:1790100675
Name:LAWRENCE, ALEXANDRA M (MS)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:M
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4100
Mailing Address - Country:US
Mailing Address - Phone:694-593-5655
Mailing Address - Fax:
Practice Address - Street 1:6767 BRENTFIELD DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2250
Practice Address - Country:US
Practice Address - Phone:694-593-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108794235Z00000X
TX109897235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist