Individual
GARY LEE AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2412 S CLIFF AVE, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Mailing address
2412 S CLIFF AVE, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7589
SD
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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