Individual
MRS. CARINDA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
963 TOWN CENTER DR, ORANGE CITY, FL 32763-8254
(386) 774-9880
(386) 774-2898
Mailing address
963 TOWN CENTER DR, STE 100, ORANGE CITY, FL 32763-8254
(386) 774-9880
(386) 774-2898
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA9464
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FE430Z
MEDICARE PTAN
FL
Enumeration date
12/08/2008
Last updated
06/23/2016
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