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Individual
MR. MARK AMBROSIOUS
Active
Individual
MR. MARK AMBROSIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR INTERN
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6598
TX
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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