| Doctor Name: | JANE B BRIDGERS-CARLOS |
| NPI Number: | 1659566396 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | C003110 |
| Business Practice Address: | 91 University Ave Sewanee, TN - 373752265 |
| Business Phone Number: | 8283319928 |
| Business Fax Number: | 9319337766 |
| Mailing Address: | 111 Proctors Hall Rd, SEWANEE |
| State: | TN |
| Postal Code: | 373752006 |
| Phone Number: | 8283319928 |
| Fax Number: | 9319337766 |
| NPI Enumeration Date: | 09/06/2007 |
| NPI Last Update Date: | 02/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C003110 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |