Provider Demographics
NPI:1295106128
Name:D'AMBROSIO, SARAH (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:D'AMBROSIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HIGHLAND AVE UNIT 3305
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2759
Mailing Address - Country:US
Mailing Address - Phone:781-354-4500
Mailing Address - Fax:
Practice Address - Street 1:205 HIGHLAND AVE UNIT 3305
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2759
Practice Address - Country:US
Practice Address - Phone:781-354-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst