Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker |
| NPI Number | 1710359690 |
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| LBN Legal business name | GET OUT OF YOUR HEAD THERAPY, LLC | ||||||||||||||||
| Authorized official | ASHLEYDAWN SHEPPARD - (OWNER) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 10/30/2015 | ||||||||||||||||
| Last updated | 12/18/2023 - About 2 years ago | ||||||||||||||||
| Identifiers |
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