Individual
KATIVA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 OLD BUNCOMBE RD, GREENVILLE, SC 29617-6250
(843) 338-2934
Mailing address
4 BLOSSOM DR, GREENVILLE, SC 29605-4907
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7509
SC
101YP2500X
Professional Counselor
7509
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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