Provider Demographics
NPI:1902403538
Name:JONES, BRIANNA KAYLIN (MA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:KAYLIN
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 GOSS ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6577
Mailing Address - Country:US
Mailing Address - Phone:678-458-8554
Mailing Address - Fax:
Practice Address - Street 1:8510 BRYANT STREET
Practice Address - Street 2:#340
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6577
Practice Address - Country:US
Practice Address - Phone:678-458-8554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional