Provider Demographics
NPI:1215020714
Name:STOUTER, JOSEPHINE H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:H
Last Name:STOUTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOSEPHINE
Other - Middle Name:T
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1910 LAKELAND DRIVE, SUITE C
Mailing Address - Street 2:QUEST,
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-713-1550
Mailing Address - Fax:601-713-0122
Practice Address - Street 1:1910 LAKELAND DRIVE, SUITE C
Practice Address - Street 2:QUEST,
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-713-1550
Practice Address - Fax:601-713-0122
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS44712103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical