Organization
WELLSPRING THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEMBI DEPASS MS/CCC-SLP (CEO)
(240) 495-1505
Entity
Organization
Contact information
Practice address
1804 WEST STREET, SUITE 300, ANNAPOLIS, MD 21401
(443) 775-5177
(410) 376-7611
Mailing address
1804 WEST STREET, SUITE 300, ANNAPOLIS, MD 21401
(443) 775-5177
(410) 376-7611
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
03772
MD
252Y00000X
Early Intervention Provider Agency
Primary
03772
MD
261QH0700X
Hearing and Speech Clinic/Center
03772
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445005100
—
MD
05
—
453755993
—
MD
Enumeration date
07/19/2013
Last updated
03/29/2021
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