Individual
SHANA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 LAKE ST, KALAMAZOO, MI 49001-3170
(269) 344-0202
(269) 344-0285
Mailing address
1608 LAKE ST, KALAMAZOO, MI 49001-3170
(269) 344-0202
(269) 344-0285
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401018911
MI
Other
Enumeration date
08/12/2020
Last updated
01/22/2021
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