Healthcare Provider Details

I. General information

NPI: 1124938790
Provider Name (Legal Business Name): FLOW THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 EDITH BLVD NE
ALBUQUERQUE NM
87102-3524
US

IV. Provider business mailing address

122 EDITH BLVD NE
ALBUQUERQUE NM
87102-3524
US

V. Phone/Fax

Practice location:
  • Phone: 575-520-2079
  • Fax:
Mailing address:
  • Phone: 575-520-2079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHRYN WOLF
Title or Position: LPC
Credential: MA
Phone: 575-520-2079