MEDICARE: DELLISA GLORIES ARMSTRONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TR0400X	Rehabilitation Psychologist

General Provider Information

NPI Number	:	1396092151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELLISA GLORIES ARMSTRONG

Provider Business Mailing Address
First Line	:	3650 N RANCHO DR STE 106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3151
Country	:	US
Telephone Number	:	702-606-8535
Fax Number	:	702-657-9892

Provider Business Practice Location Address
First Line	:	3650 N RANCHO DR STE 106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3151
Country	:	US
Telephone Number	:	702-776-6728
Fax Number	:	702-776-6728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2012
Last Update Date	:	01/19/2020

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Directions to “ DELLISA GLORIES ARMSTRONG ” Practice Location

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