Individual
MS. MARIA TERESA FAIRCLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2317 N SHERMAN AVE, ROSWELL, NM 88201-6429
(505) 227-5459
(575) 623-1240
Mailing address
11101 COLVILLE RD SE, ALBUQUERQUE, NM 87123-3708
(505) 227-5459
(575) 623-1240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0115481
NM
1041C0700X
Clinical Social Worker
Primary
M-08576
NM
Other
Enumeration date
06/05/2013
Last updated
03/03/2024
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