Individual
SOURIA KOUTARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR THERAPIST
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1552
(860) 632-3231
Mailing address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1552
(818) 345-2345
(818) 758-8015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7810
CT
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2018
Last updated
09/30/2024
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