Individual
CHARMAINE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1531 HIGHLAND COLONY PKWY, MADISON, MS 39110-7469
(601) 352-7784
(601) 968-0021
Mailing address
1717 KINGS GLEN LN, FORT WORTH, TX 76140-5784
(817) 779-2406
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/27/2016
Last updated
10/25/2018
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