Individual
MARIANNE SEVILLA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8705 SHOAL CREEK BLVD, 108, AUSTIN, TX 78757-6802
(512) 436-3225
Mailing address
5104 WOODVIEW AVE, AUSTIN, TX 78756-1905
(512) 574-5854
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
36011
TX
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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