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Individual

DR. WIDMAYER AMBROISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 PARK ST APT 2, ATTLEBORO, MA 02703-2363
(774) 719-3922
Mailing address
55 PARK ST APT 2, ATTLEBORO, MA 02703-2363
(774) 719-3922

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171R00000X
Interpreter
MA
172A00000X
Driver
MA
225800000X
Recreation Therapist
MA
225C00000X
Rehabilitation Counselor
MA
251K00000X
Public Health or Welfare Agency
MA
251S00000X
Community/Behavioral Health Agency
MA
253Z00000X
In Home Supportive Care Agency
Primary
MA
372500000X
Chore Provider
MA
372600000X
Adult Companion
MA
376J00000X
Homemaker
MA
385HR2055X
Child Mental Illness Respite Care
MA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
MA

Other

Enumeration date
10/07/2021
Last updated
05/02/2022
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