Individual
CHASSITY MARIE WILTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1619 COLLINS RD NW, KENNESAW, GA 30152-4309
(470) 531-0430
Mailing address
1206 WADE GREEN CIR NW, ACWORTH, GA 30102-3494
(702) 355-6433
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-264634
GA
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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