Healthcare Provider Details

I. General information

NPI: 1477853141
Provider Name (Legal Business Name): ELIZABETH ANN ARMBRUSTER LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SUPERIOR ST
PORT HURON MI
48060-3838
US

IV. Provider business mailing address

520 SUPERIOR ST
PORT HURON MI
48060-3838
US

V. Phone/Fax

Practice location:
  • Phone: 810-984-4202
  • Fax: 810-984-8896
Mailing address:
  • Phone: 810-984-4202
  • Fax: 810-984-8896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401012203
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: