Provider Demographics
NPI:1790572261
Name:COVENEY, SAMANTHA (RD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:COVENEY
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11009 STRONG DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-1043
Mailing Address - Country:US
Mailing Address - Phone:954-303-5574
Mailing Address - Fax:
Practice Address - Street 1:11009 STRONG DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-1043
Practice Address - Country:US
Practice Address - Phone:954-303-5574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered