| Doctor Name: | SANDY AMBROSE |
| NPI Number: | 1407918758 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NUTRITIONIST |
| License Number: | 1312 |
| Business Practice Address: | 1 Compass Way Suite 208 East Bridgewater, MA - 023331465 |
| Business Phone Number: | 5083502222 |
| Business Fax Number: | 5083502316 |
| Mailing Address: | 362 N Bedford St, EAST BRIDGEWATER |
| State: | MA |
| Postal Code: | 023331148 |
| Phone Number: | 5083502350 |
| Fax Number: | 5083502318 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 03/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 1312 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |