Individual
JENNIFER ELIZABETH BLEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1153 BOUGHTON ST APT 14G, WATERTOWN, WI 53094-3112
(920) 285-7015
Mailing address
1153 BOUGHTON ST APT 14G, WATERTOWN, WI 53094-3112
(920) 285-7015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19589-130
WI
1041C0700X
Clinical Social Worker
12608-123
WI
376K00000X
Nurse's Aide
390358
WI
Other
Enumeration date
06/20/2022
Last updated
05/17/2026
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