Individual
SHANNON BOSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2115 GRAND AVE, GRAND JUNCTION, CO 81501-8007
(970) 254-4872
Mailing address
PO BOX 424, MESA, CO 81643-0424
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003346
CO
Other
Enumeration date
11/17/2023
Last updated
02/09/2024
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