Charissa Dawn Boldridge, TLMLP

NPI #1578800199 in Emporia, Kansas

Provider Information

NPI Number: 1578800199
Entity Type: Individual
Name: Charissa Dawn Boldridge, TLMLP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: TLMLP
Enumeration Date: Jan 16, 2013
Last Updated: Jan 16, 2013

Practice Location

Address: 618 COMMERCIAL ST
City: Emporia
State: Kansas
ZIP Code: 66801-3969
Phone: (620) 343-7746

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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