Provider Demographics
NPI:1841584513
Name:GOLDSTEIN, MIRIAM (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 COLUMBINE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3100
Mailing Address - Country:US
Mailing Address - Phone:720-276-0030
Mailing Address - Fax:
Practice Address - Street 1:975 PLATTE RIVER BLVD STE 0
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4349
Practice Address - Country:US
Practice Address - Phone:303-659-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist