Individual
MS. VICKI HEINZ BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4253 MONTGOMERY BLVD NE, SUITE 220, ALBUQUERQUE, NM 87109
(505) 342-0400
(505) 342-0500
Mailing address
4253 MONTGOMERY BLVD NE, SUITE 220, ALBUQUERQUE, NM 87109
(505) 342-0400
(505) 342-0500
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0177421
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13601377
—
NM
Enumeration date
08/18/2006
Last updated
07/21/2022
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