Individual
BETHANY STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
901 FARM HOUSE LN, ROCKLIN, CA 95765-5369
(757) 777-5148
Mailing address
5828 MEADOWDALE CT, ROCKLIN, CA 95677-3644
(757) 777-5148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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