# INSIDE OUT THERAPEUTIC SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073393575
- **Authorized official:** SHANNON MAYHALL LMFT (OWNER/CEO)
- **Authorized official phone:** (760) 552-9194

## Contact information

- **Practice address:** 15490 CIVIC DR STE 101, VICTORVILLE, CA 92392-2382
- **Practice address phone:** (760) 552-9194
- **Mailing address:** 12036 DE ANZA RD, VICTORVILLE, CA 92392-1370
- **Mailing address phone:** (760) 552-9294

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2023
- **Last updated:** 01/27/2024