Latairricka07/11/198 Bolden
NPI #1508541004 in West Memphis, Arkansas
Provider Information
- NPI Number
- 1508541004
- Entity Type
- Individual
- Name
- Latairricka07/11/198 Bolden
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Jun 21, 2023
- Last Updated
- Jun 21, 2023
Practice Location
- Address
- 103 S AVALON ST
- City
- West Memphis
- State
- Arkansas
- ZIP Code
- 72301-4165
- Phone
- (870) 732-1878
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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