Individual
KRISTY MICHELLE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1938 KIMBALL AVE, BLUEFIELD, VA 24605-1155
(276) 326-1591
Mailing address
1938 KIMBALL AVE, BLUEFIELD, VA 24605-1155
(276) 326-1591
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
12/31/2011
Last updated
12/31/2011
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