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Individual

JUSTIN D'AMBROSIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA, NYS-LBA

Contact information

Practice address
17 WAYNE CT, QUEENSBURY, NY 12804-9108
(518) 744-4834
Mailing address
17 WAYNE CT, QUEENSBURY, NY 12804-9108
(518) 744-4834

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000-719-1
NY
103K00000X
Behavior Analyst
1-14-9594

Other

Enumeration date
10/29/2013
Last updated
05/08/2017
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