Larry A Stout, MSW

NPI #1124282769 in Marion, Illinois

Provider Information

NPI Number: 1124282769
Entity Type: Individual
Name: Larry A Stout, MSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: MSW
Enumeration Date: Jul 14, 2008
Last Updated: Jul 14, 2008

Practice Location

Address: 2400 W MAIN ST
City: Marion
State: Illinois
ZIP Code: 62959-1171
Phone: (618) 997-5311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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