Provider Demographics
NPI:1598292294
Name:JAYNES-FOURNIER, HALLEY (MFTC)
Entity Type:Individual
Prefix:
First Name:HALLEY
Middle Name:
Last Name:JAYNES-FOURNIER
Suffix:
Gender:F
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15944 E RICE PL APT A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6925
Mailing Address - Country:US
Mailing Address - Phone:409-771-5334
Mailing Address - Fax:
Practice Address - Street 1:15944 E RICE PL APT A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-6925
Practice Address - Country:US
Practice Address - Phone:409-771-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0013581106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist