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1811268485
MARK AMBROSIOUS
LONGVIEW, TX
NPI
1811268485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 6598)
Enumeration Date
2012-01-13
Last Update Date
2012-01-13
Business Address
Mr. MARK AMBROSIOUS Counselor Intern
950 N 4TH ST
LONGVIEW, TX 75601-5436
Phone number: 903-758-0596
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Mailing Address
Mr. MARK AMBROSIOUS Counselor Intern
PO BOX 6800
LONGVIEW, TX 75608-6800
Phone number: 903-758-2471
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