Healthcare Provider Details

I. General information

NPI: 1427488949
Provider Name (Legal Business Name): KRISTINA JOAN COTTLE FELDMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTINA JOAN COTTLE

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 S FOOTHILL DR STE 110
SALT LAKE CITY UT
84109-5402
US

IV. Provider business mailing address

2323 E SHERIDAN RD
SALT LAKE CITY UT
84108-2423
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-7782
  • Fax:
Mailing address:
  • Phone: 408-439-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: