Provider Demographics
NPI:1750555496
Name:ARMSTRONG, BRUCE O (MA)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:O
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E PARADISE ST
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-2226
Mailing Address - Country:US
Mailing Address - Phone:330-683-4246
Mailing Address - Fax:
Practice Address - Street 1:220 E PARADISE ST
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-2226
Practice Address - Country:US
Practice Address - Phone:330-683-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool