Organization
WELLSPRING MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN DOMINOWSKI LPC (OWNER)
(920) 393-8355
Entity
Organization
Contact information
Practice address
204 W MAIN ST UNIT E, HORTONVILLE, WI 54944-8556
(920) 393-8355
(920) 580-0150
Mailing address
PO BOX 165, HORTONVILLE, WI 54944-0165
(920) 393-8355
(920) 580-0150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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