Individual
MAIRA LARA AMBRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 549-6413
(406) 542-0143
Mailing address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 549-6413
(406) 542-0143
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
04/21/2021
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