Robert Daniel Fairbanks, LCSW

NPI #1164702445 in Lindon, Utah

Provider Information

NPI Number: 1164702445
Entity Type: Individual
Name: Robert Daniel Fairbanks, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Aug 18, 2011
Last Updated: Jun 17, 2015

Practice Location

Address: 200 N ANDERSON LN
City: Lindon
State: Utah
ZIP Code: 84042-1110
Phone: (801) 785-1761

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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