Individual
MRS. CARRIE BRIDWELL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
705 GATE LN STE 102, KNOXVILLE, TN 37909-3519
(865) 444-8580
Mailing address
705 GATE LN STE 102, KNOXVILLE, TN 37909-3519
(865) 444-8580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000004918
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511957
—
TN
Enumeration date
04/28/2008
Last updated
09/19/2023
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