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General NPI Number Information
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NPI Number | 1316893936
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Entity Type | Organization
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Legal Business Name | WILDFLOWER SERENITY, LLC
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 2501 SAN PEDRO DR NE STE 115
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4156
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Country | US
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Telephone | 505-804-1052
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Fax |
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Provider Business Mailing Address
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Address Line | 5608 WHEELWRIGHT AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-3361
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Country | US
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Telephone | 505-804-1052
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AMY ALBERTUS
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Credential | LPCC
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Telephone | 505-804-1052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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