Individual
GWENDOLYN FACCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4304 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4811
(505) 433-7561
Mailing address
4304 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4811
(505) 433-7561
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2024-1014
NM
1041C0700X
Clinical Social Worker
Primary
SWB-2024-1014
NM
Other
Enumeration date
07/23/2018
Last updated
03/02/2026
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