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Individual

JENNIFER D STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1515 LA 107, CENTER POINT, LA 71323
(318) 452-8200
Mailing address
31 ER SLAY RD, DEVILLE, LA 71328-9213
(318) 452-8200

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
200117
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200117
OCCUPATIONAL THERAPY LICENSE NUMBER
LA
Enumeration date
01/14/2021
Last updated
01/14/2021
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