Individual
CHASIDY ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
110 PIPEMAKERS CIR STE 116, POOLER, GA 31322-4168
(912) 330-7171
Mailing address
110 PIPEMAKERS CIR STE 116, POOLER, GA 31322-4168
(912) 330-7171
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-71652
GA
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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