Provider Demographics
NPI:1922731421
Name:GOLDSTEIN, SHULAMIS DEVORAH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHULAMIS
Middle Name:DEVORAH
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7741 GANNON AVE
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2822
Mailing Address - Country:US
Mailing Address - Phone:314-229-6051
Mailing Address - Fax:
Practice Address - Street 1:ALCHARIZI 30
Practice Address - Street 2:APARTMENT 3
Practice Address - City:JERUSALEM
Practice Address - State:ISRAEL
Practice Address - Zip Code:9232130
Practice Address - Country:IL
Practice Address - Phone:314-338-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-03
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28233235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist