Individual
ADELIA DIANE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3701 HACIENDA ST, SAN MATEO, CA 94403-4366
(650) 388-8565
Mailing address
2015 PIONEER CT STE B, SAN MATEO, CA 94403-1736
(650) 348-6603
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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