Organization
TRANQUIL MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN RANDALL LCSW (OWNER)
(918) 931-3995
Entity
Organization
Contact information
Practice address
6947 N 460 RD, HULBERT, OK 74441-3250
(918) 931-3995
Mailing address
6947 N 460 RD, HULBERT, OK 74441-3250
(918) 931-3995
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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