Provider Demographics
NPI:1083774277
Name:MURRAY, LURA VIRGINIA (M S, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LURA
Middle Name:VIRGINIA
Last Name:MURRAY
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15401 LAURA WAY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-8776
Mailing Address - Country:US
Mailing Address - Phone:501-316-0105
Mailing Address - Fax:501-603-9474
Practice Address - Street 1:6705 W 12TH ST
Practice Address - Street 2:SUITE #3
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1515
Practice Address - Country:US
Practice Address - Phone:501-603-9976
Practice Address - Fax:501-603-9474
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#678235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S807OtherBLUE CROSS BLUE SHIELD