MEDICARE: LOIS EVELYN SKON LMFT

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
1	106H00000X	Marriage & Family Therapist	7509057-3902	UT

General Provider Information

NPI Number	:	1407156011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIS EVELYN SKON LMFT

Provider Business Mailing Address
First Line	:	24 S 600 E
Second Line	:	SUITE 5
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1017
Country	:	US
Telephone Number	:	801-971-4062
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 S 600 E
Second Line	:	SUITE 5
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1017
Country	:	US
Telephone Number	:	801-971-4062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	04/09/2015

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Directions to “ LOIS EVELYN SKON LMFT” Practice Location

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