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Individual
THERESA M COVINGTON
Active
Individual
THERESA M COVINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
CT002407
CT
103TC0700X
Clinical Psychologist
Primary
012316
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT002407
LICENSE
CT
Enumeration date
11/07/2006
Last updated
01/28/2014
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