| Doctor Name: | DR. SARAH STOUT |
| NPI Number: | 1053680793 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.D. |
| License Number: | |
| Business Practice Address: | 12 Fairleigh Way Ballston Lake, NY - 120192241 |
| Business Phone Number: | 3174080110 |
| Business Fax Number: | |
| Mailing Address: | 12 Fairleigh Way, BALLSTON LAKE |
| State: | NY |
| Postal Code: | 120192241 |
| Phone Number: | 3174080110 |
| Fax Number: | |
| NPI Enumeration Date: | 12/27/2011 |
| NPI Last Update Date: | 09/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |