Healthcare Provider Details

I. General information

NPI: 1508350356
Provider Name (Legal Business Name): BRIANA MCKINNEY, BCBA, MT-BC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13458 MARION ST
THORNTON CO
80241-1950
US

IV. Provider business mailing address

16871 E 119TH AVE UNIT A
COMMERCE CITY CO
80022-6330
US

V. Phone/Fax

Practice location:
  • Phone: 216-926-9215
  • Fax:
Mailing address:
  • Phone: 720-237-7925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-18384
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number09788
License Number StateCO

VIII. Authorized Official

Name: MRS. BRIANA MCKINNEY
Title or Position: OWNER
Credential: BCBA, MT-BC
Phone: 720-237-7925