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Individual

MS. ANTOINETTE MARIE STOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
6419 S HOWELL AVE, OAK CREEK, WI 53154-1103
(414) 304-5713
Mailing address
3394 W SYCAMORE ST, FRANKLIN, WI 53132-8348
(414) 423-5409

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3494-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40911800
WI
Enumeration date
10/11/2006
Last updated
02/02/2012
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