Healthcare Provider Details

I. General information

NPI: 1104759455
Provider Name (Legal Business Name): SKYE COLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 N 1000 E
NORTH LOGAN UT
84341-1500
US

IV. Provider business mailing address

2930 N 1000 E
NORTH LOGAN UT
84341-1500
US

V. Phone/Fax

Practice location:
  • Phone: 435-213-0611
  • Fax:
Mailing address:
  • Phone: 435-213-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberRBT-24-392666
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: