Organization
WENDY GALLEGOS, M.A. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER P WALDOCK (OFFICE MANAGER)
(505) 898-2474
Entity
Organization
Contact information
Practice address
420 ASHLEY LN, CORRALES, NM 87048-8940
(505) 898-2474
(505) 899-8172
Mailing address
420 ASHLEY LN, CORRALES, NM 87048-8940
(505) 898-2474
(505) 899-8172
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
562
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231H00000X
—
NM
05
—
K2186
—
NM
Enumeration date
11/28/2011
Last updated
11/28/2011
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