Individual
ANIYA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
385 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1875
(770) 695-3708
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/24/2026
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