Individual
ALYSSA PROULX BOSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2625 REDWING RD STE 175, FORT COLLINS, CO 80526-6324
(970) 829-8841
Mailing address
PO BOX 1112, FORT COLLINS, CO 80522-1112
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCC.0019527
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPCC.0019527
DORA
CO
Enumeration date
06/23/2022
Last updated
06/23/2022
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