Provider Demographics
NPI:1427807684
Name:FURAHA, BENITA
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:
Last Name:FURAHA
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 1:5017 S 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-5779
Mailing Address - Country:US
Mailing Address - Phone:602-748-9371
Mailing Address - Fax:
Practice Address - Street 1:5017 S 108TH AVE
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-5779
Practice Address - Country:US
Practice Address - Phone:602-748-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No171W00000XOther Service ProvidersContractor