Healthcare Provider Details

I. General information

NPI: 1174443576
Provider Name (Legal Business Name): JENNIFER BLOESS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5217
EAGLE CO
81631-5217
US

IV. Provider business mailing address

PO BOX 5217
EAGLE CO
81631-5217
US

V. Phone/Fax

Practice location:
  • Phone: 970-393-0883
  • Fax:
Mailing address:
  • Phone: 970-393-0883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC.0024220
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: