Healthcare Provider Details

I. General information

NPI: 1013893924
Provider Name (Legal Business Name): ASPECTS OF SELF DYNAMICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3849 IVY PATH
SAINT HEDWIG TX
78152-0447
US

IV. Provider business mailing address

PO BOX 327
SAINT HEDWIG TX
78152-0327
US

V. Phone/Fax

Practice location:
  • Phone: 330-314-0329
  • Fax:
Mailing address:
  • Phone: 214-382-3197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHELLY TRIMBLE
Title or Position: CLINICAL SOCIAL WORKER
Credential: LISW-S, LCSW
Phone: 214-382-3197