Individual
LEIGH ANNE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CGC
Contact information
Practice address
571 S FLOYD ST, LOUISVILLE, KY 40202
(502) 588-0866
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
74000206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001244797
ANTHEM PTAN
IN
05
—
300021911
—
IN
Enumeration date
08/16/2017
Last updated
04/01/2024
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