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NPI Code Detail

MEDICARE: HAILEY MALMBERG

MEDICARE: HAILEY MALMBERG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1730987074
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEY MALMBERG
Provider Business Mailing Address
First Line : 1474 W 1075 S
Second Line :
City : LAYTON
State : UT
Zip : 84041-7772
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12055 S 700 E
Second Line :
City : DRAPER
State : UT
Zip : 84020-9746
Country : US
Telephone Number : 801-980-7970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2025
Last Update Date : 03/04/2025

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Directions to “ HAILEY MALMBERG ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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