Provider Demographics
NPI:1225851991
Name:AMBROSE, CHRISTINE FRANCES
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:FRANCES
Last Name:AMBROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:AMBROSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:303 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MILMONT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19033-3124
Mailing Address - Country:US
Mailing Address - Phone:610-405-6063
Mailing Address - Fax:
Practice Address - Street 1:303 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:MILMONT PARK
Practice Address - State:PA
Practice Address - Zip Code:19033-3124
Practice Address - Country:US
Practice Address - Phone:610-405-6063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency