| Doctor Name: | AMBROSIA D ROBERTS |
| NPI Number: | 1760519599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BS MHP |
| License Number: | |
| Business Practice Address: | 206 West 5th Street Metropolis, IL - 62960 |
| Business Phone Number: | 6185249368 |
| Business Fax Number: | 6185249551 |
| Mailing Address: | 206 West 5th Street, METROPOLIS |
| State: | IL |
| Postal Code: | 62960 |
| Phone Number: | 6185249368 |
| Fax Number: | 6185249551 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 01/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |