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Organization

TRANQUIL LIFE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA RENEE SOUTHERN LMSW (OWNER)
(810) 922-7700
Entity
Organization

Contact information

Practice address
275 S STATE RD, OTISVILLE, MI 48463-8436
(810) 374-6115
Mailing address
275 S STATE RD, OTISVILLE, MI 48463-8436
(810) 374-6115

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/22/2019
Last updated
06/13/2022
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