Provider Demographics
NPI:1194392530
Name:LOVE OUT LOUD, LLC
Entity Type:Organization
Organization Name:LOVE OUT LOUD, LLC
Other - Org Name:LOVE OUT LOUD, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LBA, BCBA
Authorized Official - Phone:254-408-0822
Mailing Address - Street 1:PO BOX 2631
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627-2631
Mailing Address - Country:US
Mailing Address - Phone:254-408-0822
Mailing Address - Fax:254-863-6056
Practice Address - Street 1:1002 WALES DR STE 6
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-1137
Practice Address - Country:US
Practice Address - Phone:254-408-0822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty