Jennifer Bleak, MD
Psychiatry & Neurology, Psychiatry in Beloit, WI. Individual provider (NPI-1).
NPI number1013124239
StatusActive
Last updated in NPPESOct 4, 2021
Details
- NPI
- 1013124239
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Bleak
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 17, 2007
- Certification date
- Oct 4, 2021
- Last updated
- Oct 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 036-083757 | WI | Yes |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 50247-20 | WI |
Practice location
Beloit Health System Counselling Care Center1969 W. Hart Rd
Beloit, WI 53511-2230
Phone 608-364-5689 · Fax 608-364-5525
Mailing address
Beloit Health System Counselling Care Center1969 W. Hart Rd
Beloit, WI 53511-2230
Phone 608-364-5689 · Fax 608-364-5525
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