Provider Demographics
NPI:1053003319
Name:COUTURE, REBECCA LOUISE (BCBA, LABA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LOUISE
Last Name:COUTURE
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LOUISE
Other - Last Name:COUTURE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA, LABA
Mailing Address - Street 1:131 SUOMI ST
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1262
Mailing Address - Country:US
Mailing Address - Phone:508-410-6558
Mailing Address - Fax:
Practice Address - Street 1:131 SUOMI ST
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:MA
Practice Address - Zip Code:01612-1262
Practice Address - Country:US
Practice Address - Phone:508-410-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-23-65197103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst