Provider Demographics
NPI:1699282046
Name:BOLDEN, SAADIA MICHELLE
Entity type:Individual
Prefix:
First Name:SAADIA
Middle Name:MICHELLE
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 1:20551 NAUMANN AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-3133
Mailing Address - Country:US
Mailing Address - Phone:216-835-4738
Mailing Address - Fax:
Practice Address - Street 1:20551 NAUMANN AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-3133
Practice Address - Country:US
Practice Address - Phone:216-835-4738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide