Individual
BRI-ANNA LACHELLE BOLDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1212 E 146TH ST, CLEVELAND, OH 44110-3625
(216) 240-7003
Mailing address
1212 E 146TH ST, CLEVELAND, OH 44110-3625
(216) 240-7003
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
149782
OH
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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