Provider Demographics
NPI:1346401304
Name:KOVNER, YVETTE DANIELLE (PSYD)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:DANIELLE
Last Name:KOVNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 CHATHAM MANOR WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21850-2097
Mailing Address - Country:US
Mailing Address - Phone:978-290-0326
Mailing Address - Fax:
Practice Address - Street 1:5262 WOODS RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3796
Practice Address - Country:US
Practice Address - Phone:410-221-2340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical