Individual
JONATHAN ROBERT AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
137 MONTGOMERY AVE STE 105, BOYERTOWN, PA 19512-1300
(800) 689-0250
Mailing address
1275 19TH ST NE, SALEM, OR 97301-2253
(717) 380-2059
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC015318
PA
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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