Individual
HEIDI STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
9948 OASIS RD, PINON HILLS, CA 92372
(760) 912-9371
Mailing address
PO BOX 721204, PINON HILLS, CA 92372-1204
(760) 912-9371
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1020603
CA
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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