Individual
ELIZABETH BRUK AMBAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2930 BLAISDELL AVE, MINNEAPOLIS, MN 55408-2345
(206) 883-1977
(651) 344-0603
Mailing address
2930 BLAISDELL AVE, MINNEAPOLIS, MN 55408-2345
(206) 883-1977
(651) 344-0603
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
G527093671414
MN
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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