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Individual

LEAH ANN TYLER STOUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
610 HIGH ST, OREGON CITY, OR 97045-2241
(503) 657-8903
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
235Z00000X
Speech-Language Pathologist
Primary
17395
OR
235Z00000X
Speech-Language Pathologist
61079694
WA

Other

Enumeration date
06/01/2018
Last updated
08/02/2023
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