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Individual

TAYLOR JOANNE FAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(575) 356-7000
Mailing address
343 S ROOSEVELT ROAD R, PORTALES, NM 88130-9011
(575) 607-5590

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
B-10661
NM
104100000X
Social Worker
M-10980
NM
104100000X
Social Worker
SWB-2022-0801
NM
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0801
NM

Other

Enumeration date
07/02/2019
Last updated
01/17/2025
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