Provider Demographics
NPI:1699125575
Name:ARMISTEAD, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ARMISTEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:ALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:11479 PINE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7308
Mailing Address - Country:US
Mailing Address - Phone:303-840-6374
Mailing Address - Fax:303-374-8290
Practice Address - Street 1:11479 PINE DR STE 1
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7308
Practice Address - Country:US
Practice Address - Phone:303-840-6374
Practice Address - Fax:303-374-8290
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5921235Z00000X
MI7101003834235Z00000X
CO0003653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM326556OtherMEDICARE
NM10171568Medicaid