Healthcare Provider Details

I. General information

NPI: 1376782888
Provider Name (Legal Business Name): SARAH BETH GOLDMAN PHD, OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2009
Last Update Date: 02/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 KANSAS ST BLDG 42 US ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE
NATICK MA
01760-2642
US

IV. Provider business mailing address

42 KANSAS ST BLDG 42 US ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE
NATICK MA
01760-2642
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-5454
  • Fax:
Mailing address:
  • Phone: 508-233-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberOT8635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: