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Organization
FINDING YOUR PATH TO FREEDOM
Active
Organization
FINDING YOUR PATH TO FREEDOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER RAE BOVEE LCSW (OWNER)
(563) 505-9529
Entity
Organization
Contact information
Practice address
2310 E OAKLAND AVE STE 11B, BLOOMINGTON, IL 61701-5881
(563) 505-9529
(309) 402-0579
Mailing address
2310 E OAKLAND AVE STE 11B, BLOOMINGTON, IL 61701-5881
(563) 505-9529
(309) 402-0579
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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