Organization
FUNDAMENTAL THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA RODRIGUEZ LCSW (LICENSED CLINICAL SOCIAL WORKER)
(505) 353-0800
Entity
Organization
Contact information
Practice address
500 MARQUETTE AVE NW STE 1277, ALBUQUERQUE, NM 87102-5340
(505) 353-0800
Mailing address
8501 VISTA SERENA LN SW, ALBUQUERQUE, NM 87121-7650
(505) 908-8267
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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