Individual
LEYANA CANDICE AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
325 E UNIVERSITY BLVD APT 67, MELBOURNE, FL 32901-7075
(585) 503-5902
Mailing address
325 E UNIVERSITY BLVD APT 67, MELBOURNE, FL 32901-7075
(585) 503-5902
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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