Organization
PEDERSEN WELLNESS AND REJUVENATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ERIKA PEDERSEN LMHC (OWNER)
(806) 543-1429
Entity
Organization
Contact information
Practice address
1740 GRANDE BLVD SE STE E15, RIO RANCHO, NM 87124-1799
(505) 507-1584
Mailing address
9108 MANRESA DR NW, ALBUQUERQUE, NM 87114-6471
(806) 543-1429
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/12/2023
Last updated
06/26/2023
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