Provider Demographics
NPI:1982012746
Name:VON SCHULZ, JONNA (PHD)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:
Last Name:VON SCHULZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JONNA
Other - Middle Name:L
Other - Last Name:HALPHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7469 SPY GLASS CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3717
Mailing Address - Country:US
Mailing Address - Phone:601-467-2507
Mailing Address - Fax:601-467-2507
Practice Address - Street 1:1650 W 121ST AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2302
Practice Address - Country:US
Practice Address - Phone:601-467-2507
Practice Address - Fax:601-467-2507
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004347103TC2200X
1-14-9703103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst