Provider Demographics
NPI:1396587838
Name:COVA, LAURA LEE (MS SLP CF)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:COVA
Suffix:
Gender:F
Credentials:MS SLP CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7444
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7444
Mailing Address - Country:US
Mailing Address - Phone:406-471-7384
Mailing Address - Fax:
Practice Address - Street 1:115 N 3RD ST W APT 1
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3664
Practice Address - Country:US
Practice Address - Phone:406-471-7384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-LTD-LIC-339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist