Individual
MRS. VIVIAN LASHAWN FAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
9521 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87113-2237
(505) 923-8074
Mailing address
9521 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87113-2237
(505) 923-8074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0179571
NM
Other
Enumeration date
08/08/2019
Last updated
08/22/2019
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