Provider Demographics
NPI:1164955035
Name:COVINGTON, JILL (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
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 1:2319 RUDOLPHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2228
Mailing Address - Country:US
Mailing Address - Phone:931-920-4333
Mailing Address - Fax:931-920-4346
Practice Address - Street 1:2319 RUDOLPHTOWN RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2228
Practice Address - Country:US
Practice Address - Phone:931-920-4333
Practice Address - Fax:931-920-4346
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5625225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist