MR. JAKARTA AGNEW

Behavior Technician

Active Individual
NPI: 1407504095

Practice Address

139 E OLD TRENTON RD STE B
Clarksville, TN 37043

Phone: (931) 444-1449

Specialties

Specialty Code Primary License
Behavior Technician 106S00000X Yes -

Frequently Asked Questions

NPI 1407504095 is the National Provider Identifier for MR. JAKARTA AGNEW, a Behavior Technician provider located in Clarksville, TN. This NPI was enumerated on March 14, 2022.
MR. JAKARTA AGNEW practices at 139 E OLD TRENTON RD STE B, Clarksville, TN 37043.

Quick Facts

NPI
1407504095
Type
Individual
Enumerated
Mar 14, 2022
Last Updated
Mar 14, 2022

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