Individual provider · Type 1 NPI

Ellis Stout

Professional Counselor · Tahlequah, OK

NPI number 1124379342 Active

Practice location

1606 E Downing St
Tahlequah, OK 74464-2573

Call (918) 453-1217 Map

Fax (918) 453-0971

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X3039 (OK)

Professional Counselor: Definition to come...

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About NPI 1124379342

Ellis Stout's National Provider Identifier is 1124379342, issued on Sep 27, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Tahlequah, OK. The record was last updated on Sep 27, 2012.