Individual
BONNIE BLAKELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
129 PHELPS AVE, SUITE 204, ROCKFORD, IL 61108-2453
(815) 227-9771
(815) 227-9793
Mailing address
3603 CORBRIDGE LN, ROCKFORD, IL 61107-3545
(815) 227-9771
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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