Organization
CROSS ROOTS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA LOPEZ VIETS (OWNER)
(505) 273-2030
Entity
Organization
Contact information
Practice address
121 WELLESLEY DR SE, ALBUQUERQUE, NM 87106-1443
(505) 273-2030
Mailing address
12231 ACADEMY RD NE SUITE 301, PMB 295, ALBUQUERQUE, NM 87111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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