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General NPI Number Information
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NPI Number | 1821229402
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Entity Type | Individual
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Provider Name | NICOLE M COUTURE M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 786 FRANKLIN RD
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City | JAY
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State | ME
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Zip | 04239-4648
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Country | US
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Telephone | 617-909-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 786 FRANKLIN RD
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City | JAY
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State | ME
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Zip | 04239-4648
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Country | US
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Telephone | 617-909-3577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-084811
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License Number State | ME
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