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General NPI Number Information
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NPI Number | 1639004625
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Entity Type | Organization
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Legal Business Name | SEEDS TO ROOTS THERAPY, LLC
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 5216 WESTWIND ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-5705
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Country | US
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Telephone | 818-426-8984
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Fax |
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Provider Business Mailing Address
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Address Line | 11318 OVERLOOK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-5711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DARA ZAFRAN
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Credential | PSY.D
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Telephone | 818-426-8984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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