Individual
VANESSA LOPEZ-VIETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
401 SAN MATEO BLVD SE, ALBUQUERQUE, NM 87108
(505) 462-7333
(505) 462-7368
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5364
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0959
NM
Other
Enumeration date
10/15/2009
Last updated
11/24/2009
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