Individual provider · Type 1 NPI
Larry E. Blossom, M.A.
Professional Counselor · Pueblo, CO
NPI number
1366503138
Active
Practice location
611 S Union Ave Apt A
Pueblo, CO 81004-2250
Mailing address
3225 Independence Rd
Canon City, CO 81212-9380
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 0701002333 (VA) |
Professional Counselor: Definition to come...
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About NPI 1366503138
Larry E. Blossom, M.A.'s National Provider Identifier is 1366503138, issued on Dec 13, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Pueblo, CO. The record was last updated on Apr 19, 2022.