Provider Demographics
NPI:1538537725
Name:KAUFFMAN, HEATHER S
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:S
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 S ELM CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3507
Mailing Address - Country:US
Mailing Address - Phone:303-809-0848
Mailing Address - Fax:
Practice Address - Street 1:6605 S ELM CIR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3507
Practice Address - Country:US
Practice Address - Phone:303-809-0848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14481077903251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services