Individual
KRISTEN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
453 US ROUTE 1, KITTERY, ME 03904-5513
(207) 451-1750
(207) 439-4360
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0826
NH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4164
ME
Other
Enumeration date
12/10/2010
Last updated
11/26/2012
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