Provider Demographics
NPI:1174531958
Name:ARMSTRONG, MIRANDA KAY (PHD)
Entity type:Individual
Prefix:MS
First Name:MIRANDA
Middle Name:KAY
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35403-2170
Mailing Address - Country:US
Mailing Address - Phone:205-344-3321
Mailing Address - Fax:205-553-3323
Practice Address - Street 1:2810 8TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2108
Practice Address - Country:US
Practice Address - Phone:205-344-3321
Practice Address - Fax:205-553-3323
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00037842OtherRR MEDICARE
AL051099204OtherBCBS
ALP00037842OtherRR MEDICARE
P22344Medicare UPIN