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Individual
CARLOS GOLSTON
Active
Individual
CARLOS GOLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC, SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005797
GA
235Z00000X
Speech-Language Pathologist
3264
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10054102
AMERIGROUP
GA
01
—
341979
WELLCARE
GA
05
—
SA0404
—
SC
Enumeration date
10/24/2006
Last updated
07/09/2007
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