Individual
MR. DARRELL DENNIS BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6803086771
MI
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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