Provider Demographics
NPI:1144039280
Name:BOLDEN, PATRICIA DANIELLE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DANIELLE
Last Name:BOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W MARKET ST STE 105
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947
Mailing Address - Country:US
Mailing Address - Phone:302-778-9222
Mailing Address - Fax:302-403-8253
Practice Address - Street 1:501 W MARKET ST
Practice Address - Street 2:STE 105
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947
Practice Address - Country:US
Practice Address - Phone:302-778-9222
Practice Address - Fax:302-403-8253
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)