MEDICARE: HEATHER S KAUFFMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	14481077903	CO

General Provider Information

NPI Number	:	1538537725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER S KAUFFMAN

Provider Business Mailing Address
First Line	:	6605 S ELM CIR
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80121-3507
Country	:	US
Telephone Number	:	303-809-0848
Fax Number	:

Provider Business Practice Location Address
First Line	:	6605 S ELM CIR
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80121-3507
Country	:	US
Telephone Number	:	303-809-0848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	09/04/2015

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Directions to “ HEATHER S KAUFFMAN ” Practice Location

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