Individual
MELISSA L FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3901 LOUISIANA BLVD NE STE C, ALBUQUERQUE, NM 87110-1448
(505) 888-1686
(505) 888-1683
Mailing address
3901 LOUISIANA BLVD NE STE C, ALBUQUERQUE, NM 87110-1448
(505) 888-1686
(505) 888-1683
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0184771
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64079775
—
NM
Enumeration date
10/17/2006
Last updated
04/21/2017
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