| NPI | 1255579918 |
|---|---|
| Doing Business As | LIFE CHANGES |
| Entity Type | Organization |
| Authorized Contact | JONATHAN E. GOLDBERG President/CEO 617-928-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8500) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |