Provider Demographics
NPI:1447446547
Name:STOUT, DENISE ANN (LOTR)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANN
Last Name:STOUT
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 OWNBY LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6331
Mailing Address - Country:US
Mailing Address - Phone:817-756-2349
Mailing Address - Fax:
Practice Address - Street 1:2229 N CARROLL BLVD
Practice Address - Street 2:DENTON NURSING AND REHABILITATION CENTER - REHABCARE
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1833
Practice Address - Country:US
Practice Address - Phone:940-395-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109826225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist