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Deonte' Bolden

Behavior Technician in St Petersburg, FL. Individual provider (NPI-1).

NPI number1023744166
StatusActive
Last updated in NPPESJul 30, 2022

Details

NPI
1023744166
Entity type
Individual (NPI-1)
Name
Deonte' Bolden
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 30, 2022
Certification date
Jul 30, 2022
Last updated
Jul 30, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

441 33rd St N Apt 407
St Petersburg, FL 33713-9036

Phone 269-254-1212

Mailing address

11901 4th St N Apt 10207
St Petersburg, FL 33716-1740

Phone 727-331-9718

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