Individual provider · Type 1 NPI

Evan Proulx Bostrom

Mental Health Counselor · Fort Collins, CO

NPI number 1194461335 Active

Practice location

2625 Redwing Rd Ste 175
Fort Collins, CO 80526-6324

Call (970) 363-6651 Map

Mailing address

PO Box 1112
Fort Collins, CO 80522-1112

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLPCC.0019543 (CO)

Mental Health Counselor: Definition to come...

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About NPI 1194461335

Evan Proulx Bostrom's National Provider Identifier is 1194461335, issued on May 10, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Collins, CO. The record was last updated on May 10, 2022.