Individual
MADRA STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH-LANGUAGE PATH
Contact information
Practice address
9405 HIGHWAY 17 BYP, MURRELLS INLET, SC 29576-9301
(423) 773-0488
Mailing address
PO BOX 14003, MYRTLE BEACH, SC 29587-4003
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5786
SC
Other
Enumeration date
08/10/2015
Last updated
10/17/2016
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