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Organization
FAIRBOURNE GROUP
Active
Organization
FAIRBOURNE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLIN GALT CMHC (OWNER/DIRECTOR)
(801) 608-1934
Entity
Organization
Contact information
Practice address
145 E 900 S STE 6, SALT LAKE CITY, UT 84111-4241
(385) 722-4505
Mailing address
145 E 900 S STE 6, SALT LAKE CITY, UT 84111-4241
(385) 722-4505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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