# JENNIFER FAIRBOURN LMFT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cottonwood Creek Counseling
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356826036
- **Authorized official:** MS. JENNIFER FAIRBOURN MS (LMFT)
- **Authorized official phone:** (801) 878-4327

## Contact information

- **Practice address:** 7321 S STATE ST STE A, MIDVALE, UT 84047-6105
- **Practice address phone:** (801) 878-4327
- **Practice address fax:** (801) 878-9280
- **Mailing address:** 7321 S STATE ST STE A, MIDVALE, UT 84047-6105
- **Mailing address phone:** (801) 878-4327
- **Mailing address fax:** (801) 878-9280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2018
- **Last updated:** 08/16/2022