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General NPI Number Information
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NPI Number | 1154185155
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Entity Type | Organization
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Legal Business Name | TRANQUILITY PREMIER COUNSELING, LLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 1145 M ST
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City | GERING
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State | NE
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Zip | 69341-2835
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Country | US
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Telephone | 308-633-3703
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 11TH AVE
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-2611
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Country | US
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Telephone | 308-765-8971
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. ALICIA DOMINGUEZ
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Credential |
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Telephone | 308-765-8971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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