Organization
SERIOUS SOBRIETY AND BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERWIN BOLDEN LPC (OWNER)
(405) 476-8483
Entity
Organization
Contact information
Practice address
3412 SE 47TH ST, OKLAHOMA CITY, OK 73135-1308
(405) 476-8483
Mailing address
3412 SE 47TH ST, OKLAHOMA CITY, OK 73135-1308
(405) 476-8483
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5484
OK
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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