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Organization
INSIDE OUT THERAPEUTIC SERVICES LLC
Active
Organization
INSIDE OUT THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MAYHALL LMFT (OWNER/CEO)
(760) 552-9194
Entity
Organization
Contact information
Practice address
15490 CIVIC DR STE 101, VICTORVILLE, CA 92392-2382
(760) 552-9194
Mailing address
12036 DE ANZA RD, VICTORVILLE, CA 92392-1370
(760) 552-9294
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
01/27/2024
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