Individual
MAIRA LARA AMBRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
9 14TH AVE W, POLSON, MT 59860-5321
(406) 883-4378
Mailing address
9 14TH AVE W, POLSON, MT 59860-5321
(406) 883-4378
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
235Z00000X
Speech-Language Pathologist
Primary
PRD-SP-LIC-12708
MT
Other
Enumeration date
02/23/2021
Last updated
06/03/2026
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