Organization
WELLSPRING MENTAL HEALTH
Active
Other names
Mary Camille Cunningham
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CAMILLE CUNNINGHAM (SOLE MBR)
(505) 331-7815
Entity
Organization
Contact information
Practice address
5400 PHOENIX AVE NE, ALBUQUERQUE, NM 87110-3144
(505) 331-7815
Mailing address
5400 PHOENIX AVE NE, ALBUQUERQUE, NM 87110-3144
(505) 331-7815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40870502
—
NM
Enumeration date
02/14/2019
Last updated
02/14/2019
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