Individual
PENNY JANE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 STATE ROUTE 47 E, BELLEFONTAINE, OH 43311-9546
(937) 592-4909
Mailing address
PO BOX 281, 5452 CR 26, BELLEFONTAINE, OH 43311-0281
(937) 355-2842
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
2240926
OH
Other
Enumeration date
03/11/2007
Last updated
07/08/2007
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