Provider Demographics
NPI:1881245991
Name:KLINE, BREANNE LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:BREANNE
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6881 S HOLLY CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1145
Mailing Address - Country:US
Mailing Address - Phone:303-834-1026
Mailing Address - Fax:
Practice Address - Street 1:6881 S HOLLY CIR STE 205
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1145
Practice Address - Country:US
Practice Address - Phone:303-834-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0006916103TC0700X
106S00000X, 390200000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician