Provider Demographics
NPI:1023136975
Name:ARMSTRONG, TANYA L (MS, SLP)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:L
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N9463 BLOOMINGROSE LN
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-5204
Mailing Address - Country:US
Mailing Address - Phone:920-993-1912
Mailing Address - Fax:
Practice Address - Street 1:N9463 BLOOMINGROSE LN
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-5204
Practice Address - Country:US
Practice Address - Phone:920-993-1912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42782800Medicaid