Provider Demographics
NPI:1821826512
Name:AGLUGUB, JEAHNA
Entity type:Individual
Prefix:
First Name:JEAHNA
Middle Name:
Last Name:AGLUGUB
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 1:1867 MCNEIL CIR
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8724
Mailing Address - Country:US
Mailing Address - Phone:360-704-0359
Mailing Address - Fax:
Practice Address - Street 1:1867 MCNEIL CIR
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-8724
Practice Address - Country:US
Practice Address - Phone:360-742-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician