Individual
DR. JOHN LAWRENCE MALOUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4460 S HIGHLAND DR STE 100, SALT LAKE CITY, UT 84124-3550
(801) 539-7000
Mailing address
4460 S HIGHLAND DR STE 100, SALT LAKE CITY, UT 84124-3550
(801) 539-7000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
107339-2501
UT
103TC0700X
Clinical Psychologist
221073392501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007001402101
INTERMOUNTAIN HEALTH CARE
UT
01
—
261751
DESERET MUTUAL
UT
01
—
942938348MA5
EDUCATORS MUTUAL
UT
01
—
R34637
MEDICARE ADVANTAGE
UT
Enumeration date
12/07/2005
Last updated
04/13/2022
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