Individual
MRS. AMANDA LYNN STOUT
Active
Individual
MRS. AMANDA LYNN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801104295
MI
1041C0700X
Clinical Social Worker
Primary
6801116399
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801104295
PRIVATE PRACTICE
MI
05
—
6801104295
—
MI
Enumeration date
05/09/2019
Last updated
05/11/2023
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