Provider Demographics
NPI:1427488949
Name:FELDMAN, KRISTINA JOAN COTTLE (PHD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:JOAN COTTLE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:JOAN
Other - Last Name:COTTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2323 E SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2423
Mailing Address - Country:US
Mailing Address - Phone:408-439-7279
Mailing Address - Fax:
Practice Address - Street 1:2319 S FOOTHILL DR STE 240
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1488
Practice Address - Country:US
Practice Address - Phone:801-382-7782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor