Provider Demographics
NPI:1538656780
Name:COVIELLO, DANIELLE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:COVIELLO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BROWNLEA DR APT 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-1643
Mailing Address - Country:US
Mailing Address - Phone:203-826-6807
Mailing Address - Fax:
Practice Address - Street 1:1717 W 5TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1603
Practice Address - Country:US
Practice Address - Phone:203-826-6807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20000273542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer