Individual
ALICIA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5445 W SOUTHPORT RD, INDIANAPOLIS, IN 46221-9699
(317) 778-6955
Mailing address
5445 W SOUTHPORT RD, INDIANAPOLIS, IN 46221-9699
(317) 778-6955
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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