Individual
HEATHER DOMKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1217 RIVERSIDE AVE, FORT COLLINS, CO 80524-3218
(970) 494-4200
Mailing address
125 CRESTRIDGE ST, FORT COLLINS, CO 80525-3934
(970) 494-4200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
CO
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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