Individual
BRUCE BOECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1100 BEECH ST, #10 NORMANDY VILLAGE, NORMAL, IL 61761-1493
(309) 454-2112
Mailing address
207 SUELYNN DR, NORMAL, IL 61761-1339
(309) 454-1371
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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