Provider Demographics
NPI:1003701582
Name:HARMALA, AMBER MARIE (APSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:HARMALA
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1435 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3918
Mailing Address - Country:US
Mailing Address - Phone:715-504-6419
Mailing Address - Fax:
Practice Address - Street 1:1435 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3918
Practice Address - Country:US
Practice Address - Phone:715-504-6419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135547104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker