Individual
ALEXIS FAWN LAZARUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
4 CHEROKEE LN, COMMACK, NY 11725-4604
(631) 241-1284
Mailing address
4 CHEROKEE LN, COMMACK, NY 11725-4604
(631) 241-1284
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
024009
NY
Other
Enumeration date
07/02/2013
Last updated
06/15/2015
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