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Katelyn Alexis Ambrose

Behavior Technician in South Portland, ME. Individual provider (NPI-1).

NPI number1194564310
StatusActive
Last updated in NPPESMay 20, 2024

Details

NPI
1194564310
Entity type
Individual (NPI-1)
Name
Katelyn Alexis Ambrose
Sex
Female
Sole proprietor
No
Enumeration date
May 20, 2024
Certification date
May 20, 2024
Last updated
May 20, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior TechnicianSA5610090MAYes

Practice location

50 Donald B Dean Dr
South Portland, ME 04106-3373

Phone 207-274-2528

Mailing address

50 Donald B Dean Dr
South Portland, ME 04106-3373

Phone 207-274-2528

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