Healthcare Provider Details

I. General information

NPI: 1255816609
Provider Name (Legal Business Name): BREIGH JONES-COPLIN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S VINE ST
DENVER CO
80210-5264
US

IV. Provider business mailing address

2450 S VINE ST OFC 134
DENVER CO
80210-5264
US

V. Phone/Fax

Practice location:
  • Phone: 303-871-3626
  • Fax:
Mailing address:
  • Phone: 901-289-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY0006410
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: