Individual
JENNIFER STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
798 CENTRAL AVE, DOVER, NH 03820-2520
(603) 609-6690
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 609-6690
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1578
NH
104100000X
Social Worker
MC9787
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3077743
—
NH
05
—
431744199
—
ME
Enumeration date
08/16/2006
Last updated
02/05/2019
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