Individual
MRS. ALI AMBROSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IMH8420
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
Mailing address
PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5043-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629384524
—
WI
Enumeration date
08/30/2010
Last updated
11/09/2020
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