| Therapeutic Life Changes, Llc | |
|
634 9th Ave W Dickinson ND 58601-4745 | |
| (701) 483-5259 | |
| (701) 483-5259 |
| Full Name | Therapeutic Life Changes, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 634 9th Ave W, Dickinson, North Dakota |
| Authorized Official Name and Position | Tamara Jo Anderson (PRESIDENT) |
| Authorized Official Contact | 7014835259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Life Changes, Llc 634 9th Ave W Dickinson ND 58601-4745 Ph: (701) 483-5259 | Therapeutic Life Changes, Llc 634 9th Ave W Dickinson ND 58601-4745 Ph: (701) 483-5259 |
| NPI Number | 1336385970 |
|---|---|
| Provider Enumeration Date | 01/04/2009 |
| Last Update Date | 01/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336385970 | NPI | - | NPPES |
| 19242 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3000 (North Dakota) | Primary |
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