Organization
LAVENDER ROOTS THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN V SANDOVAL LMFT (OWNER)
(505) 490-1998
Entity
Organization
Contact information
Practice address
1401 SOAVE DR SE, RIO RANCHO, NM 87124-8849
(505) 490-1998
Mailing address
1401 SOAVE DR SE, RIO RANCHO, NM 87124-8849
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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