Individual
AMBROSIA MITZI LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9019 WASHINGTON ST NE, ALBUQUERQUE, NM 87113-2435
(718) 215-5311
Mailing address
9500 JUAN VALDEZ ST SE, ALBUQUERQUE, NM 87123-5205
(505) 238-3048
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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