Individual
MARANDA BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4906 MERLIN CIRCLE, APT 4906, SHREVEPORT, LA 71108
(682) 276-9850
Mailing address
4906 MERLIN CIR, SHREVEPORT, LA 71107-4526
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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