Provider Demographics
NPI:1194962795
Name:COUVERTIERE, JEANNINE
Entity type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:COUVERTIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9620 STONE CANYON LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3552
Mailing Address - Country:US
Mailing Address - Phone:865-548-8053
Mailing Address - Fax:
Practice Address - Street 1:10710 MURDOCK DR STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3257
Practice Address - Country:US
Practice Address - Phone:865-548-8053
Practice Address - Fax:865-200-4996
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist