| Mrs Bethany S Stout, LADC | |
|
1095 Nickerson St, Waynoka, OK 73860-1252 | |
| (580) 824-0674 | |
| Not Available |
| Full Name | Mrs Bethany S Stout |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1095 Nickerson St, Waynoka, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801019146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 764 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Bethany S Stout, LADC 409 Oklahoma Blvd, Alva, OK 73717-2711 Ph: (580) 327-1825 | Mrs Bethany S Stout, LADC 1095 Nickerson St, Waynoka, OK 73860-1252 Ph: (580) 824-0674 |
Mrs. Kayla Louise Mcclain, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Nickerson St, Waynoka, OK 73860 Phone: 580-824-0674 | |
Mrs. Ashley Nicole Ferguson, BS IN SOCIAL WORK Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Nickerson St, Waynoka, OK 73860 Phone: 580-824-0674 Fax: 580-824-0676 |