Provider Demographics
NPI:1417496712
Name:CLINGER, SHEALYN
Entity Type:Individual
Prefix:
First Name:SHEALYN
Middle Name:
Last Name:CLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 FORESTIVEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-8872
Mailing Address - Country:US
Mailing Address - Phone:571-241-1180
Mailing Address - Fax:
Practice Address - Street 1:9000 FORESTVIEW DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-3336
Practice Address - Country:US
Practice Address - Phone:571-241-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician