Individual
VICTORIA ROSALYN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5000 HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29588-4500
(843) 252-0033
Mailing address
5000 HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29588-4500
(843) 252-0033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5309
SC
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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