Individual
TRACY R. FAWVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5345 WYOMING BLVD NE STE 107, ALBUQUERQUE, NM 87109-3193
(505) 238-3345
Mailing address
9577 OSUNA RD NE STE B, ALBUQUERQUE, NM 87111-2286
(505) 433-7405
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-11646
NM
1041C0700X
Clinical Social Worker
Primary
M-11646
NM
Other
Enumeration date
08/31/2021
Last updated
04/17/2026
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