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1124379342
ELLIS STOUT
TAHLEQUAH, OK
NPI
1124379342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK 3039)
Enumeration Date
2012-09-27
Last Update Date
2012-09-27
Business Address
-- ELLIS STOUT
1606 E DOWNING ST
TAHLEQUAH, OK 74464-2573
Phone number: 918-453-1217
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Mailing Address
-- ELLIS STOUT
1606 E DOWNING ST
TAHLEQUAH, OK 74464-2573
Phone number: 918-453-1217
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