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Individual

DURRELL J BOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15208 SE TIBBETTS ST, PORTLAND, OR 97236-2356
(503) 760-0959
(503) 761-0041
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/05/2017
Last updated
09/05/2017
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