# THERAPEUTIC LIFE CHANGES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336385970
- **Authorized official:** MS. TAMARA JO ANDERSON LICSW (PRESIDENT)
- **Authorized official phone:** (701) 483-5259

## Contact information

- **Practice address:** 634 9TH AVE W, DICKINSON, ND 58601-4745
- **Practice address phone:** (701) 483-5259
- **Practice address fax:** (701) 483-5259
- **Mailing address:** 634 9TH AVE W, DICKINSON, ND 58601-4745
- **Mailing address phone:** (701) 483-5259
- **Mailing address fax:** (701) 483-5259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 3000 | ND | Yes |

## Other

- **Enumeration date:** 01/04/2009
- **Last updated:** 01/04/2009