Provider Demographics
NPI:1063192334
Name:GOLDSTEIN, ASHLEY (MS SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BRAINERD RD APT 401
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-4564
Mailing Address - Country:US
Mailing Address - Phone:224-545-1981
Mailing Address - Fax:
Practice Address - Street 1:74 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1147
Practice Address - Country:US
Practice Address - Phone:617-969-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist