Provider Demographics
NPI:1831971191
Name:LAZOUR INVESTMENT LLC
Entity type:Organization
Organization Name:LAZOUR INVESTMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZOURENKO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC MS SLP
Authorized Official - Phone:171-869-6953
Mailing Address - Street 1:1245 AVENUE X APT M1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4253
Mailing Address - Country:US
Mailing Address - Phone:718-696-9531
Mailing Address - Fax:
Practice Address - Street 1:1245 AVENUE X APT M1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4253
Practice Address - Country:US
Practice Address - Phone:718-696-9531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency