Doctor Name: | JESSICA L STOUT |
NPI Number: | 1033430673 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 4455 Ne Highway 20 Corvallis, OR - 97330 |
Business Phone Number: | 5417581107 |
Business Fax Number: | |
Mailing Address: | 4455 Ne Highway 20, CORVALLIS |
State: | OR |
Postal Code: | 973309695 |
Phone Number: | 5417581107 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2010 |
NPI Last Update Date: | 06/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |