1841517950 NPI number — KRISTEN L COUTU MS, OTR/L

Table of content: KRISTEN L COUTU MS, OTR/L (NPI 1841517950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841517950 NPI number — KRISTEN L COUTU MS, OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COUTU
Provider First Name:
KRISTEN
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841517950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46 SPIRIT WIND FARM RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-651-3838
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CHILD DEVELOPMENT SERVICES YORK
Provider Second Line Business Practice Location Address:
39 LIMERICK RD.
Provider Business Practice Location Address City Name:
ARUNDEL
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-324-8481
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  2044 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0200X , with the licence number: 2292 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)