Individual
JARED AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3623 SAUNDERS AVE, RICHMOND, VA 23227-4354
(804) 601-6751
Mailing address
1314 MISTYVALE ST, HERNDON, VA 20170-3629
(703) 407-5011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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