Covington, Theresa M

Covington, Theresa M is an sole proprietor health care provider with primary practice located at 2605 Brewerton Rd , Mattydale NY 13211-1147. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Covington, Theresa M can be contacted via phone (315) 935-3037.

Contact Information

Primary practice address
2605 Brewerton Rd Mattydale NY 13211-1147
Phone: (315) 935-3037
Fax: (315) 295-2614
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X CT002407 Connecticut
Behavioral Health & Social Service Providers / Clinical 103TC0700X 012316 New York

Profile Details

NPI number 1952470635
LBN Legal business name Covington, Theresa M
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2006
Last updated Jan 28th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952470635 NPPES
Connecticut Other CT002407 LICENSE

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