Provider Information for 1629617071
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KATRINA RENEE COVINGTON LCPC
Sex: Female
NPI: 1629617071
Last Updated: 2024-01-31
Certification Date: 2024-01-31
Certification Date: 2024-01-31
Details
Name | Value | ||||||||||||||
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NPI | 1629617071 | ||||||||||||||
Enumeration Date | 2020-01-02 | ||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||
Sole Proprietor | NO | ||||||||||||||
Status | Active | ||||||||||||||
Mailing Address | 8305 FOXBOROUGH WAY JOLIET, IL 60431-7806 United States Phone: 910-787-0938 | Fax: | ||||||||||||||
Primary Practice Address | 350 HOUBOLT RD STE 210 JOLIET, IL 60431-8305 United States Phone: 815-869-7956 | Fax: | ||||||||||||||
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