Individual
MS. G KELLI STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
194 S MAIN ST, PLEASANT GROVE, UT 84062-2631
(801) 785-1169
(801) 785-1154
Mailing address
2184 N 800 W, PROVO, UT 84604-1261
(801) 472-3476
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8311530-3502
UT
Other
Enumeration date
11/20/2013
Last updated
11/20/2013
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