Provider Demographics
NPI:1235843368
Name:COUILLARD, ALLISON BARBARA
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BARBARA
Last Name:COUILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BROADWAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4506
Mailing Address - Country:US
Mailing Address - Phone:978-609-1192
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE WAY
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3626
Practice Address - Country:US
Practice Address - Phone:487-897-8762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker