Provider Demographics
NPI:1053734343
Name:ARMSTRONG, PRESTON LEON
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:LEON
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37800 MACARTHUR ST
Mailing Address - Street 2:LOT 22
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-9265
Mailing Address - Country:US
Mailing Address - Phone:405-481-1864
Mailing Address - Fax:
Practice Address - Street 1:37800 W. MACARTHUR ST
Practice Address - Street 2:LOT 22
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-9265
Practice Address - Country:US
Practice Address - Phone:405-481-1864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor