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1508541004
LATAIRRICKA07/11/198 BOLDEN
WEST MEMPHIS, AR
NPI
1508541004
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-06-21
Last Update Date
2023-06-21
Business Address
LATAIRRICKA07/11/198 BOLDEN
103 S AVALON ST
WEST MEMPHIS, AR 72301-4165
Phone number: 870-732-1878
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Mailing Address
LATAIRRICKA07/11/198 BOLDEN
103 S AVALON ST
WEST MEMPHIS, AR 72301-4165
Phone number: 870-732-1878
Copy
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