Organization
SPECTRUM THERAPY SERVICES
Active
Other names
Nikki D Stout
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI D STOUT OTR (OWNER)
(804) 205-0355
Entity
Organization
Contact information
Practice address
1825 BLACKWOOD DR, MAIDENS, VA 23102-2526
(804) 205-0355
Mailing address
1825 BLACKWOOD DR, MAIDENS, VA 23102-2526
(804) 205-0355
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
133V00000X
Registered Dietitian
—
—
225800000X
Recreation Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/13/2024
Last updated
11/19/2024
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