Individual
CASEY LEE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
212 IRIS RD, SEWICKLEY, PA 15143-2402
(412) 741-2375
(724) 647-1570
Mailing address
4538 PEACH ST, ERIE, PA 16509-1364
(181) 486-4665
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC015335
PA
Other
Enumeration date
10/09/2020
Last updated
10/12/2020
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