Provider Demographics
NPI:1205190246
Name:COUTURIER, KELLY ALLINSON (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ALLINSON
Last Name:COUTURIER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1465 WOODBURY AVE
Mailing Address - Street 2:#375
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3210
Mailing Address - Country:US
Mailing Address - Phone:603-812-5521
Mailing Address - Fax:603-580-5362
Practice Address - Street 1:1465 WOODBURY AVE
Practice Address - Street 2:#375
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3210
Practice Address - Country:US
Practice Address - Phone:603-812-5521
Practice Address - Fax:603-580-5362
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1-10-7349103K00000X
1-10-7349103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst