Provider Demographics
NPI:1629447420
Name:ARMBRUSTER, PEGGY (LSW)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:ARMBRUSTER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 N RIDGE RD E STE E
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3400
Mailing Address - Country:US
Mailing Address - Phone:440-213-1772
Mailing Address - Fax:
Practice Address - Street 1:2173 N RIDGE RD E STE E
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3400
Practice Address - Country:US
Practice Address - Phone:440-213-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1501077104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker