Provider Demographics
NPI:1679765812
Name:CARUSO, HEIDI (BS)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:CARUSO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2018 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2413
Mailing Address - Country:US
Mailing Address - Phone:719-671-2093
Mailing Address - Fax:719-315-2629
Practice Address - Street 1:2018 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2413
Practice Address - Country:US
Practice Address - Phone:719-671-2093
Practice Address - Fax:719-315-2629
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist