Individual
MOLLY ELIZABETH WANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12443 WOODIN RD, CHARDON, OH 44024-9130
(440) 725-0920
Mailing address
12443 WOODIN RD, CHARDON, OH 44024-9130
(440) 725-0920
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31347
OH
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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