Provider Demographics
NPI:1578731345
Name:STOUK, OLYA (NMD)
Entity Type:Individual
Prefix:
First Name:OLYA
Middle Name:
Last Name:STOUK
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONE POINTE INSTITUTE, 2950 S. ALMA SCHOOL RD,
Mailing Address - Street 2:SUITE # 8
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210
Mailing Address - Country:US
Mailing Address - Phone:480-838-3287
Mailing Address - Fax:480-838-0150
Practice Address - Street 1:STONE POINTE INSTITUTE, 2950 S. ALMA SCHOOL RD,
Practice Address - Street 2:SUITE # 8
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210
Practice Address - Country:US
Practice Address - Phone:480-838-3287
Practice Address - Fax:480-838-0150
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-726175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath