| Inner Path Wellness, Llc | |
|
200 Rosemont Ave Ne Apt C Albuquerque NM 87102-1599 | |
| (505) 750-3605 | |
| (505) 340-3941 |
| Full Name | Inner Path Wellness, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 200 Rosemont Ave Ne Apt C, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jessica Ayesha Rodrigues Sundram (OWNER) |
| Authorized Official Contact | 5057503605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Path Wellness, Llc 300 Menaul Blvd Nw Ste A Pmb 468 Albuquerque NM 87107-9951 Ph: (505) 750-3605 | Inner Path Wellness, Llc 200 Rosemont Ave Ne Apt C Albuquerque NM 87102-1599 Ph: (505) 750-3605 |
| NPI Number | 1831617448 |
|---|---|
| Provider Enumeration Date | 09/03/2017 |
| Last Update Date | 07/20/2021 |
| Certification Date | 07/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831617448 | NPI | - | NPPES |
| 59605251 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C-09020 (New Mexico) | Primary |
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