Individual
MRS. AMANDA LYNN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
5340 PLYMOUTH ROAD, SUITE 202, ANN ARBOR, MI 48105
(734) 462-3210
(734) 369-6084
Mailing address
5340 PLYMOUTH ROAD, SUITE 202, ANN ARBOR, MI 48105
(734) 883-4218
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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