Individual
VICTORIA AMBORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
622 ALCOA RD, BENTON, AR 72015-3420
(501) 352-1359
(501) 325-1919
Mailing address
1201 MILITARY RD STE 1, BENTON, AR 72015-2922
(501) 352-1359
(501) 325-1919
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
P2511015
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/14/2019
Last updated
04/29/2026
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