Provider Demographics
NPI:1104499839
Name:CARLOW, TANGULIN D (MSW)
Entity type:Individual
Prefix:MS
First Name:TANGULIN
Middle Name:D
Last Name:CARLOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 CASTELNAU CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4900
Mailing Address - Country:US
Mailing Address - Phone:850-345-6206
Mailing Address - Fax:
Practice Address - Street 1:20274 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424-1957
Practice Address - Country:US
Practice Address - Phone:850-674-8888
Practice Address - Fax:850-237-1223
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor