Healthcare Provider Details

I. General information

NPI: 1003774068
Provider Name (Legal Business Name): MALORIE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 N COVE DR
CEDAR CITY UT
84720-2242
US

IV. Provider business mailing address

PO BOX 623
MILFORD UT
84751-0623
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-0754
  • Fax:
Mailing address:
  • Phone: 435-572-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: