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Individual

MS. CATHY L STOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
803 STADIUM DR STE 101, ARLINGTON, TX 76011-6246
(817) 459-2003
(817) 459-1898
Mailing address
1205 WILSHIRE BLVD, ARLINGTON, TX 76012-4632
(817) 266-5472

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
39661
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
286918YRK5
MEDICARE
TX
05
319625501
TX
01
319625502
MEDICAID CSHCN
TX
01
89131Q
BLUE CROSS BLUE SHIELD
Enumeration date
08/08/2010
Last updated
01/16/2014
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