Organization
BLOOMINGLIFE LLC
Active
Other names
BloomingLife LLC
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA TURNER LPCC (OWNER)
(616) 275-2288
Entity
Organization
Contact information
Practice address
221 TROWBRIDGE ST NE APT 208, GRAND RAPIDS, MI 49503-1891
(616) 499-7711
Mailing address
1121 BRETON RD SE, GRAND RAPIDS, MI 49506-3529
(616) 275-2288
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401003114
STATE OF MICHIGAN LICENSE
MI
Enumeration date
06/04/2019
Last updated
06/04/2019
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