Provider Demographics
NPI:1396595880
Name:FURTH, LORIE
Entity type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:FURTH
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 1:1611 E MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-7825
Mailing Address - Country:US
Mailing Address - Phone:865-595-0220
Mailing Address - Fax:
Practice Address - Street 1:440 EDWARDS LN
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854-4764
Practice Address - Country:US
Practice Address - Phone:973-615-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician