Individual
ALEXIS STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
54 N. MAIN STREET, CLOVERDALE, IN 46120
(765) 301-9285
Mailing address
54 N. MAIN STREET, CLOVERDALE, IN 46120
(765) 301-9285
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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