Individual
HEATHER TKACZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6612 GULTON CT NE STE B, ALBUQUERQUE, NM 87109-4407
(505) 633-7886
(505) 521-5165
Mailing address
6612 GULTON CT NE STE B, ALBUQUERQUE, NM 87109-4407
(505) 633-7886
(505) 521-5165
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NM
1041C0700X
Clinical Social Worker
—
NM
172V00000X
Community Health Worker
Primary
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
06/07/2025
Last updated
10/21/2025
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