Individual
JENNIFER BLEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
BELOIT HEALTH SYSTEM COUNSELLING CARE CENTER, 1969 W. HART RD, BELOIT, WI 53511-2230
(608) 364-5689
(608) 364-5525
Mailing address
BELOIT HEALTH SYSTEM COUNSELLING CARE CENTER, 1969 W. HART RD, BELOIT, WI 53511-2230
(608) 364-5689
(608) 364-5525
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-083757
WI
2084P0800X
Psychiatry Physician
50247-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002708
—
WI
Enumeration date
05/17/2007
Last updated
10/04/2021
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