Individual
JONAH GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 KNOWLES ST, 2, PROVIDENCE, RI 02906-1709
(401) 484-2289
Mailing address
11 KNOWLES ST, 2, PROVIDENCE, RI 02906-1709
(401) 484-2289
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3978
MA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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