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NPI Code Detail

MEDICARE: KIYAH MARIE WENTZ

MEDICARE: KIYAH MARIE WENTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianOH

General Provider Information

NPI Number : 1386594356
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIYAH MARIE WENTZ
Provider Business Mailing Address
First Line : 182 MARLOW RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-3044
Country : US
Telephone Number : 419-747-4122
Fax Number :
Provider Business Practice Location Address
First Line : 1033 LARCHWOOD RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2424
Country : US
Telephone Number : 419-747-4122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2026
Last Update Date : 01/30/2026

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Directions to “ KIYAH MARIE WENTZ ” Practice Location

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