Provider Demographics
NPI:1477066124
Name:MURDOCK, KRISTEN K (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:K
Last Name:MURDOCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 S 225 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6975
Mailing Address - Country:US
Mailing Address - Phone:858-228-7781
Mailing Address - Fax:
Practice Address - Street 1:1171 S 225 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6975
Practice Address - Country:US
Practice Address - Phone:858-228-7781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool