Provider Demographics
NPI:1972302859
Name:MCCLINTON, ANIYAH FATEEMA
Entity type:Individual
Prefix:
First Name:ANIYAH
Middle Name:FATEEMA
Last Name:MCCLINTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 ROCKINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7360
Mailing Address - Country:US
Mailing Address - Phone:678-751-8247
Mailing Address - Fax:
Practice Address - Street 1:5712 ROCKINGWOOD DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7360
Practice Address - Country:US
Practice Address - Phone:678-751-8247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician