Individual
LUCILLE ALYSE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
95 CONNELL ST, JASPER, GA 30143-1767
(706) 502-1241
Mailing address
95 CONNELL ST, JASPER, GA 30143-1767
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/09/2026
Last updated
02/09/2026
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