Individual
DEAYSHA LASHAWN BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 W I 240 SERVICE RD, OKLAHOMA CITY, OK 73139-7701
(405) 635-3853
(405) 604-9689
Mailing address
301 W I 240 SERVICE RD, OKLAHOMA CITY, OK 73139-7701
(405) 635-3853
(405) 604-9689
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
07/28/2021
Last updated
07/27/2022
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