Provider Demographics
NPI:1770543241
Name:STOUT, JULIE (LMFT)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:STOUT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 S 1300 E
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2550
Mailing Address - Country:US
Mailing Address - Phone:801-699-4149
Mailing Address - Fax:801-665-2434
Practice Address - Street 1:5667 S REDWOOD RD UNIT 5B
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5495
Practice Address - Country:US
Practice Address - Phone:801-699-4149
Practice Address - Fax:801-665-2434
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49139393902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist