Individual
CHANDLER FAYE WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
30755 BARRINGTON ST, MADISON HEIGHTS, MI 48071-1833
(248) 965-3916
Mailing address
30755 BARRINGTON ST, MADISON HEIGHTS, MI 48071-1833
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35459
GA
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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