Healthcare Provider Details
I. General information
NPI: 1295658706
Provider Name (Legal Business Name): EMMA COVITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1391 CAREY CT
CARMEL IN
46032-9223
US
IV. Provider business mailing address
1391 CAREY CT
CARMEL IN
46032-9223
US
V. Phone/Fax
- Phone: 317-225-2665
- Fax:
- Phone: 317-225-2665
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: