Individual
ADRIANNA MALASSIA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4931 RIVERSIDE DR, MACON, GA 31210-1156
(800) 701-0498
Mailing address
4931 RIVERSIDE DR, MACON, GA 31210-1156
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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