Individual
BREONNA IRIE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2965 FORT CAMPBELL BLVD STE 600, CLARKSVILLE, TN 37042-0405
(844) 854-1116
Mailing address
3438 N HENDERSON WAY, CLARKSVILLE, TN 37042-5699
(931) 395-4195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
07/27/2026
Last updated
07/27/2026
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