Provider Demographics
NPI:1053472811
Name:ARMBRUSTER, ALICE P (SLP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:P
Last Name:ARMBRUSTER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15406 N CASTILLO DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-1640
Mailing Address - Country:US
Mailing Address - Phone:480-836-1077
Mailing Address - Fax:
Practice Address - Street 1:15406 N CASTILLO DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-1640
Practice Address - Country:US
Practice Address - Phone:480-836-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ431949Medicaid
AZZ130018Medicare PIN
AZ431949Medicaid