Individual
TAMIKA S. BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2760 DORA AVE., TAVARES, FL 32778
(352) 742-7837
(352) 742-7837
Mailing address
2760 DORA AVE., TAVARES, FL 32778
(352) 742-7837
(352) 742-7837
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11164
FL
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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