Individual
LA DONNA MICHELLE BOLDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6241 S EBERHART AVE, CHICAGO, IL 60637-3318
(404) 441-9053
Mailing address
6241 S EBERHART AVE, CHICAGO, IL 60637-3318
(404) 441-9053
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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