Healthcare Provider Details

I. General information

NPI: 1609527902
Provider Name (Legal Business Name): ANDRAYA ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 RAVINES EDGE CT
COLUMBUS OH
43235-5426
US

IV. Provider business mailing address

6400 E BROAD ST STE 400
COLUMBUS OH
43213-2979
US

V. Phone/Fax

Practice location:
  • Phone: 614-985-3112
  • Fax:
Mailing address:
  • Phone: 614-655-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: