Organization
CHANGING LIVES 2GETHER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATARSCHA PALMER (OWNER)
(812) 204-7696
Entity
Organization
Contact information
Practice address
5287 BARRINGTON TRACE DR SW, ATLANTA, GA 30331-7898
(812) 204-7696
Mailing address
5287 BARRINGTON TRACE DR SW, ATLANTA, GA 30331-7898
(812) 204-7696
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/24/2019
Last updated
08/25/2019
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