Gina Marie Ambrose

Individual provider Active NPI Behavior Technician · Ogden, UT

NPI 1639094352 · NPPES record last updated Aug 11, 2026

Key facts

NPI
1639094352
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
349 12TH St
Ogden, UT 84404-5712
Phone
(801) 335-9382
NPI assigned
Aug 11, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

349 12TH St
Ogden, UT 84404-5712

Mailing address

349 12TH St
Ogden, UT 84404-5712
Phone (801) 335-9382

Other providers in Ogden, UT

All providers in Ogden, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.