Provider Demographics
NPI:1346368396
Name:EVERS KILLEBREW, JESSICA LEAH (PSYD)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEAH
Last Name:EVERS KILLEBREW
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEAH EVERS
Other - Last Name:KILLEBREW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:103 ROOSEVELT AVE APT B
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2172
Mailing Address - Country:US
Mailing Address - Phone:858-353-8083
Mailing Address - Fax:
Practice Address - Street 1:2503 WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5745
Practice Address - Country:US
Practice Address - Phone:858-353-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health