Individual
COLLETTA CHESNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3675 CRESTWOOD PKWY NW STE 472, DULUTH, GA 30096-5136
(212) 470-0577
Mailing address
3675 CRESTWOOD PKWY NW, DULUTH, GA 30096-1805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT22223656
GA
3747A0650X
Attendant Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000
—
GA
Enumeration date
07/20/2022
Last updated
07/21/2022
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