Healthcare Provider Details

I. General information

NPI: 1548183965
Provider Name (Legal Business Name): HEATHER KUCKUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S OLD TOM MORRIS RD
AURORA CO
80018-6013
US

IV. Provider business mailing address

1728 FAIRACRE DR
GREELEY CO
80631-5324
US

V. Phone/Fax

Practice location:
  • Phone: 303-366-0579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: