MEDICARE: MS. CARMEN J STOUT MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP7970	AR

General Provider Information

NPI Number	:	1235215674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMEN J STOUT MS, CCC-SLP

Provider Business Mailing Address
First Line	:	4207 PARK AVE
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-9473
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4207 PARK AVE
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-9473
Country	:	US
Telephone Number	:	501-701-1701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	04/17/2012

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Directions to “ MS. CARMEN J STOUT MS, CCC-SLP” Practice Location

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