Provider Demographics
NPI:1396092151
Name:ARMSTRONG, DELLISA GLORIES
Entity type:Individual
Prefix:
First Name:DELLISA
Middle Name:GLORIES
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 N RANCHO DR STE 106
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3151
Mailing Address - Country:US
Mailing Address - Phone:702-606-8535
Mailing Address - Fax:702-657-9892
Practice Address - Street 1:3650 N RANCHO DR STE 106
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3151
Practice Address - Country:US
Practice Address - Phone:702-776-6728
Practice Address - Fax:702-776-6728
Is Sole Proprietor?:No
Enumeration Date:2012-08-12
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation