Provider Demographics
NPI:1871023788
Name:GOLDSTEIN, TAMARA (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11705 W 164TH PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-7988
Mailing Address - Country:US
Mailing Address - Phone:913-558-0333
Mailing Address - Fax:
Practice Address - Street 1:20375 W 151ST ST STE 270
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5360
Practice Address - Country:US
Practice Address - Phone:913-780-4263
Practice Address - Fax:913-780-2796
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01608225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand