Individual
MADELYN BOLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W QUINCY ST, BROKEN ARROW, OK 74012-5219
(918) 645-3881
Mailing address
6646 E 26TH CT, TULSA, OK 74129-6104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF600
OK
Other
Enumeration date
08/09/2023
Last updated
09/13/2024
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