Stout, Antoinette Marie
Stout, Antoinette Marie is an sole proprietor health care provider with primary practice located at 6419 S Howell Ave , Oak Creek WI 53154-1103. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Stout, Antoinette Marie can be contacted via phone (414) 304-5713.Contact Information
Primary practice address
6419 S Howell Ave
Oak Creek WI 53154-1103
Phone: (414) 304-5713
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3494-125 | Wisconsin |
Profile Details
| NPI number | 1336237478 |
|---|---|
| LBN Legal business name | Stout, Antoinette Marie |
| Credentials | MS, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Feb 2nd, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336237478 | NPPES |
| Wisconsin | MEDICAID | 40911800 |
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