Individual
MS. SUSAN SHAYNE GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11125 SCHUETZ RD, SAINT LOUIS, MO 63146-4909
(314) 853-3914
(314) 692-8113
Mailing address
11125 SCHUETZ RD, SAINT LOUIS, MO 63146-4909
(314) 853-3914
(314) 692-8113
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004019225
MO
225XE0001X
Environmental Modification Occupational Therapist
2004019225
MO
225XG0600X
Gerontology Occupational Therapist
2004019225
MO
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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