Individual
JESSICA L STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330
(541) 758-1107
Mailing address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-1107
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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