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NPI Code Detail

MEDICARE: KELLIE CLARA COUPAL BCBA

MEDICARE: KELLIE CLARA COUPAL BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1669323549
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE CLARA COUPAL BCBA
Provider Business Mailing Address
First Line : 1839 N 2ND ST APT 1
Second Line :
City : HARRISBURG
State : PA
Zip : 17102-2244
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1649 61ST ST FL 3
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-2746
Country : US
Telephone Number : 717-497-7003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ KELLIE CLARA COUPAL BCBA” Practice Location

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