Provider Demographics
NPI:1124169941
Name:FURR, LILLIAN ROSE
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:ROSE
Last Name:FURR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 S PANTANO PKWY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-5873
Mailing Address - Country:US
Mailing Address - Phone:520-396-4555
Mailing Address - Fax:
Practice Address - Street 1:700 S SARNOFF DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-4248
Practice Address - Country:US
Practice Address - Phone:520-731-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist