Organization
CHANGE OF LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER D NEWCOMER LCSW (SOLE PROPRIETOR)
(816) 529-5990
Entity
Organization
Contact information
Practice address
7280 NW 87TH TER, STE 210, KANSAS CITY, MO 64153-3720
(816) 529-5990
Mailing address
4602 NE 83RD TER, KANSAS CITY, MO 64119-7617
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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