| Doctor Name: | MRS. TRACY ELLEN AMBOS |
| NPI Number: | 1487010971 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW-C, LICSW |
| License Number: | LC303237 |
| Business Practice Address: | 5100 Fetcher Avenue Joint Base Andrews, MD - 20762 |
| Business Phone Number: | 2406127600 |
| Business Fax Number: | |
| Mailing Address: | 7124 Langley Ct, HUGHESVILLE |
| State: | MD |
| Postal Code: | 206372714 |
| Phone Number: | 2405775528 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2016 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC303237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |