Healthcare Provider Details

I. General information

NPI: 1669898540
Provider Name (Legal Business Name): LAURA BENNETT MURPHY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 E SOUTH TEMPLE SUITE 120
SALT LAKE CITY UT
84102-1142
US

IV. Provider business mailing address

699 E SOUTH TEMPLE SUITE 120
SALT LAKE CITY UT
84102-1142
US

V. Phone/Fax

Practice location:
  • Phone: 801-893-1778
  • Fax:
Mailing address:
  • Phone: 801-893-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number67780022501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: