Individual
ELIZABETH STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 ESSEX ST UNIT 1, SALEM, MA 01970-5210
(617) 221-5196
Mailing address
701 SOUTH ST STE 100, MOUNTAIN HOME, AR 72653-4452
(617) 221-5196
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
12-29AEPL
AR
103T00000X
Psychologist
Primary
PSY5000260
MA
Other
Enumeration date
08/27/2012
Last updated
04/17/2023
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