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Individual

ALYSSIA NIOBE BOLDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
5331 PRIMROSE LAKE CIR STE 103, TAMPA, FL 33647-3764
(727) 386-9255
Mailing address
5233 US HIGHWAY 98 N, LAKELAND, FL 33809-0533
(813) 708-9030

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1041C0700X
Clinical Social Worker
Primary
SW21883
FL

Other

Enumeration date
12/07/2020
Last updated
01/14/2026
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