Individual
EMBERLY VON WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4143 COLUMBIA RD STE B, MARTINEZ, GA 30907-5405
(706) 755-2785
(706) 755-2783
Mailing address
4143 COLUMBIA RD STE B, MARTINEZ, GA 30907-5405
(706) 755-2785
(706) 755-2783
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-131904
CO
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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