WAYNE FAVREAU

ESPANOLA, NM
NPI1730278854
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor Professional
(Licence: NM  0100411)
Additional Taxonomies101YM0800X Counselor Mental Health
(Licence: NM  0100411)
Enumeration Date2006-10-12
Last Update Date2015-10-15
Business Address
WAYNE FAVREAU LPCC
1302 CALLE DE LA MERCED
ESPANOLA, NM 87532-2624
Phone number: 505-747-0081
Mailing Address
WAYNE FAVREAU LPCC
2551 COORS BLVD NW
ALBUQUERQUE, NM 87120-1213
Phone number: 505-338-3320