Individual
REBECCA CHRISTENSEN FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2020 S LAKE ST, SALT LAKE CITY, UT 84105-3119
(801) 487-7778
(435) 652-6354
Mailing address
1760 W 4805 S, TAYLORSVILLE, UT 84129-1177
(801) 955-9110
(801) 955-9411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
117144
MA
1041C0700X
Clinical Social Worker
Primary
8890207-3501
UT
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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