Provider Demographics
NPI:1346313152
Name:COVAULT, CAROL ANN
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:COVAULT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:KLIMKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3487 S LINDEN RD STE R
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3025
Mailing Address - Country:US
Mailing Address - Phone:810-213-1011
Mailing Address - Fax:810-230-0679
Practice Address - Street 1:3487 S LINDEN RD STE R
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3025
Practice Address - Country:US
Practice Address - Phone:810-213-1011
Practice Address - Fax:810-230-0679
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501001327237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist