Individual
MRS. JENNY LOUISE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
809 JAMESWAY DR, WATERTOWN, WI 53098-1701
(920) 988-3061
Mailing address
809 JAMESWAY DR, WATERTOWN, WI 53098-1701
(920) 988-3061
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1292-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42744100
—
WI
Enumeration date
04/27/2008
Last updated
04/27/2008
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