Provider Demographics
NPI:1427872423
Name:OVERBY, LEXANDRA A (OTR)
Entity type:Individual
Prefix:
First Name:LEXANDRA
Middle Name:A
Last Name:OVERBY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 LOOKOUT LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-1286
Mailing Address - Country:US
Mailing Address - Phone:502-604-3672
Mailing Address - Fax:
Practice Address - Street 1:1001 CROSSFIELD DR
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1599
Practice Address - Country:US
Practice Address - Phone:859-753-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273781225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist