Bruce Boeck LCPC

NPI 1063614600 - Counselor - 101YP2500X

NPI Details
NPI 1063614600
Gender Male
Enumeration Date 06/05/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1100 BEECH ST
#10 NORMANDY VILLAGE
NORMAL IL, 61761-1493, US
Phone (309) 454-2112
Fax
Business Location
207 SUELYNN DR
NORMAL IL, 61761-1339, US
Phone (309) 454-1371
Fax
Toxanomy
Taxonomy Code 101YP2500X
License State
License Number
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According to our database, Bruce Boeck LCPC NPI is 1063614600, taxonomy code is 101YP2500X Bruce Boeck LCPC physically located at 1100 Beech St, Normal IL, 61761-1493. NPI Number Bruce Boeck LCPC has the Individual type.

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1063614600 NPI number is provided on an as is basis without warranty of any kind. 1063614600 is maintained by the National Plan & Provider Enumeration System. The contents of Bruce Boeck LCPC are for informational purposes only.