Individual
RAINY STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 E COVINA BLVD, COVINA, CA 91724-1523
(626) 966-1632
Mailing address
1161 E COVINA BLVD, COVINA, CA 91724-1523
(626) 966-1632
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
842629
CA
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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