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Individual
MRS. JACQUELINE R AMBROSE
Active
Individual
MRS. JACQUELINE R AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, ADCES
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
911825
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20810009
ASSOCIATION OF DIABETES CARE & EDUCATION SPECIALIST
—
Enumeration date
02/08/2020
Last updated
02/08/2020
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