Provider Demographics
NPI:1053691717
Name:FINDING YOUR PATH TO FREEDOM
Entity type:Organization
Organization Name:FINDING YOUR PATH TO FREEDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:BOVEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:563-505-9529
Mailing Address - Street 1:2310 E OAKLAND AVE STE 11B
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-5881
Mailing Address - Country:US
Mailing Address - Phone:563-505-9529
Mailing Address - Fax:309-402-0579
Practice Address - Street 1:2310 E OAKLAND AVE STE 11B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-5881
Practice Address - Country:US
Practice Address - Phone:563-505-9529
Practice Address - Fax:309-402-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty