Provider Demographics
NPI:1346653094
Name:DONNIAQUO, HEIDI SABRINA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:SABRINA
Last Name:DONNIAQUO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5738
Mailing Address - Country:US
Mailing Address - Phone:602-241-4724
Mailing Address - Fax:602-230-9132
Practice Address - Street 1:1366 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5738
Practice Address - Country:US
Practice Address - Phone:602-241-4724
Practice Address - Fax:602-230-9132
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 108131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical