Individual
MRS. MARY A GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1501 6TH ST STE C, LA GRANDE, OR 97850-2419
(541) 963-6715
(541) 962-7440
Mailing address
PO BOX 1005, LA GRANDE, OR 97850-1005
(541) 962-0162
(541) 962-0119
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2874
OR
Other
Enumeration date
08/08/2006
Last updated
06/05/2018
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