Provider Demographics
NPI:1598389827
Name:BRIONEZ, JULIO (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:
Last Name:BRIONEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:BRIONEZ LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:710 E GARFIELD ST STE 325
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3985
Mailing Address - Country:US
Mailing Address - Phone:307-352-9554
Mailing Address - Fax:
Practice Address - Street 1:710 E GARFIELD ST STE 325
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3985
Practice Address - Country:US
Practice Address - Phone:307-352-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY683103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling