Individual
NAOMI KATHLEEN STAUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2025 OAK PARK BLVD, LAKE CHARLES, LA 70601-7827
(337) 477-8214
Mailing address
2104 CREOLE ST APT 1, LAKE CHARLES, LA 70601-7192
(316) 204-7208
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200262
LA
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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