Provider Demographics
NPI:1144404302
Name:COVINGTON, FREDERICK BERNARD (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:BERNARD
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20203 GOSHEN ROAD
Mailing Address - Street 2:SUITE #131
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-0000
Mailing Address - Country:US
Mailing Address - Phone:240-498-2412
Mailing Address - Fax:866-743-5360
Practice Address - Street 1:20203 GOSHEN RD
Practice Address - Street 2:SUITE #131
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-4000
Practice Address - Country:US
Practice Address - Phone:240-498-2412
Practice Address - Fax:866-743-5360
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist