Healthcare Provider Details

I. General information

NPI: 1609486950
Provider Name (Legal Business Name): COVE CHILD DEVELOPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KAILUA RD STE 102B
KAILUA HI
96734-3420
US

IV. Provider business mailing address

130 KAILUA RD STE 102B
KAILUA HI
96734-3420
US

V. Phone/Fax

Practice location:
  • Phone: 808-400-0073
  • Fax: 808-707-8237
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: AUBREANNA ELIZABETH COVERT
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 480-489-3954