Organization
WELLSPRING HEALING
Active
Organization
WELLSPRING HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRA GENDUSO LMT, LMHC (OWNER)
(505) 690-6679
Entity
Organization
Contact information
Practice address
1800 OLD PECOS TRL STE B, SANTA FE, NM 87505-4787
(505) 690-6679
Mailing address
8 GRAYHAWK PL, SANTA FE, NM 87508-1332
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
4830
NM
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2018
Last updated
03/16/2022
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