Provider Demographics
NPI:1972838845
Name:BOW, DENISE ANNETTE (MA, NCC, LCPC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ANNETTE
Last Name:BOW
Suffix:
Gender:F
Credentials:MA, NCC, LCPC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ANNETTE
Other - Last Name:BESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 E WAR MEMORIAL DR STE D
Mailing Address - Street 2:
Mailing Address - City:PEORIA HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:61616-7548
Mailing Address - Country:US
Mailing Address - Phone:309-326-5820
Mailing Address - Fax:309-403-0346
Practice Address - Street 1:712 E WAR MEMORIAL DR STE D
Practice Address - Street 2:
Practice Address - City:PEORIA HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:61616-7548
Practice Address - Country:US
Practice Address - Phone:309-326-5820
Practice Address - Fax:309-403-0346
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor