Provider Demographics
NPI:1407156011
Name:SKON, LOIS EVELYN (LMFT)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:EVELYN
Last Name:SKON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:L
Other - Middle Name:EVELYN
Other - Last Name:SKON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:24 S 600 E
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1017
Mailing Address - Country:US
Mailing Address - Phone:801-971-4062
Mailing Address - Fax:
Practice Address - Street 1:24 S 600 E
Practice Address - Street 2:SUITE 5
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1017
Practice Address - Country:US
Practice Address - Phone:801-971-4062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7509057-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist