Individual
MRS. BETHANY PAIGE BLEDSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
233 OIL WELL RD, SUITE C, JACKSON, TN 38305-8014
(731) 660-8467
Mailing address
66 LYNWOOD DR, JACKSON, TN 38301-4235
(731) 695-1339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4468
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3987481
—
TN
01
—
4138245
BCBS - TN
TN
Enumeration date
09/21/2006
Last updated
07/08/2007
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