Individual
MRS. SHANNON GOLDSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 VETERANS MEMORIAL DR, BOULDER CITY, NV 89005-1926
(702) 332-6784
Mailing address
768 CHRISTINA DR, BOULDER CITY, NV 89005-3425
(602) 738-9790
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2543
NV
Other
Enumeration date
08/09/2020
Last updated
08/09/2020
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