| Inside Out Therapeutic Services Llc | |
|
15490 Civic Dr Ste 101 Victorville CA 92392-2382 | |
| (760) 552-9194 | |
| Not Available |
| Full Name | Inside Out Therapeutic Services Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 15490 Civic Dr Ste 101, Victorville, California |
| Authorized Official Name and Position | Shannon Mayhall (OWNER/CEO) |
| Authorized Official Contact | 7605529194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inside Out Therapeutic Services Llc 12036 De Anza Rd Victorville CA 92392-1370 Ph: (760) 552-9294 | Inside Out Therapeutic Services Llc 15490 Civic Dr Ste 101 Victorville CA 92392-2382 Ph: (760) 552-9194 |
| NPI Number | 1073393575 |
|---|---|
| Provider Enumeration Date | 10/02/2023 |
| Last Update Date | 01/27/2024 |
| Certification Date | 01/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073393575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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