Provider Demographics
NPI:1851662969
Name:ARMBRUST, LISA-MAE SINCLAIR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LISA-MAE
Middle Name:SINCLAIR
Last Name:ARMBRUST
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111-70 SAN JOSE BLVD
Mailing Address - Street 2:#185
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11111 SAN JOSE BLVD STE 70
Practice Address - Street 2:#185
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-7274
Practice Address - Country:US
Practice Address - Phone:904-718-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7420103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist