Organization Name: | BENNETT BRIDGERS-CARLOS |
NPI Number: | 1437518990 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANE BENNETT BRIDGERS-CARLOS (OWNER) |
Mailing Address: | 91 University Ave Sewanee |
State: | TN US |
Postal Code: | 373752265 |
Phone Number: | 8283319928 |
Fax Number: | 9319337766 |
NPI Enumeration Date: | 02/12/2016 |
NPI Last Update Date: | 02/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LSW5973 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |