Provider Demographics
NPI:1588206221
Name:ARMSTRONG, DENISE LYNN
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:LYNN
Other - Last Name:THOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1325 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-3203
Mailing Address - Country:US
Mailing Address - Phone:603-381-4404
Mailing Address - Fax:
Practice Address - Street 1:1325 S 36TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-3203
Practice Address - Country:US
Practice Address - Phone:603-381-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician