Individual
NATHAN THOMAS FASENMYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 LEAD AVE SW, ALBUQUERQUE, NM 87102-3164
(724) 508-5335
Mailing address
611 LEAD AVE SW, ALBUQUERQUE, NM 87102-3164
(724) 508-5335
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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