Individual
JEFF FOWLER STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5598941-6009
UT
Other
Enumeration date
07/30/2006
Last updated
02/20/2025
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