Individual
AMIE ROSE BOMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 AMS CT, GREEN BAY, WI 54313-9704
(920) 544-4970
Mailing address
1040 MORAINE WAY APT 1, GREEN BAY, WI 54303-9420
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
515-140
WI
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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