Healthcare Provider Details

I. General information

NPI: 1780091900
Provider Name (Legal Business Name): LOUISE CARPENTER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 E DUNSTABLE RD STE 3&4
NASHUA NH
03062-4223
US

IV. Provider business mailing address

6225 SMITH AVE STE 1001A
BALTIMORE MD
21209-3626
US

V. Phone/Fax

Practice location:
  • Phone: 508-363-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50913
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: