Individual
MARLEE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 366-9100
Mailing address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2130
WV
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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