Individual
ILYSE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3100 ARAPAHOE AVE STE 101, BOULDER, CO 80303-1050
(130) 393-1849
Mailing address
3100 ARAPAHOE AVE STE 101, BOULDER, CO 80303-1050
(130) 393-1849
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1739
CO
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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