Individual
MRS. LACRESA MARIE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1800 W DIVISION ST, HENRYETTA, OK 74437-3815
(918) 652-6500
Mailing address
1800 W DIVISION ST, HENRYETTA, OK 74437-3815
(918) 652-6500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2729
OK
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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