Provider Demographics
NPI:1548068455
Name:MCGARY, ANISSA
Entity type:Individual
Prefix:
First Name:ANISSA
Middle Name:
Last Name:MCGARY
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 1:750 FOREST PARK LN
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2583
Mailing Address - Country:US
Mailing Address - Phone:678-617-2062
Mailing Address - Fax:
Practice Address - Street 1:750 FOREST PARK LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2583
Practice Address - Country:US
Practice Address - Phone:678-617-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant