Provider Demographics
NPI:1497082275
Name:MCADAMS, AMBROSIA DAWN (RBT)
Entity Type:Individual
Prefix:MRS
First Name:AMBROSIA
Middle Name:DAWN
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10242 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6507
Mailing Address - Country:US
Mailing Address - Phone:772-643-2714
Mailing Address - Fax:
Practice Address - Street 1:10242 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6507
Practice Address - Country:US
Practice Address - Phone:772-643-2714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA52358106S00000X, 225700000X
106S00000X
FLRBT21-178756106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist