Provider Demographics
NPI:1043996507
Name:THRASH, LEXIE (LCAT-LP)
Entity type:Individual
Prefix:
First Name:LEXIE
Middle Name:
Last Name:THRASH
Suffix:
Gender:F
Credentials:LCAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 GUERNSEY ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2896
Mailing Address - Country:US
Mailing Address - Phone:301-471-8850
Mailing Address - Fax:
Practice Address - Street 1:142 GUERNSEY ST APT 1R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2896
Practice Address - Country:US
Practice Address - Phone:301-471-8850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP122449225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist