Individual
CONNY HEISCHKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(970) 222-2027
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(970) 222-2027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW-991272
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11702578
MEDICARE PTAN
CO
Enumeration date
05/17/2007
Last updated
08/18/2016
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