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NPI Code Detail

MEDICARE: CELESTE GOSHORN

MEDICARE: CELESTE GOSHORN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1639567159
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELESTE GOSHORN
Provider Business Mailing Address
First Line : 9183 W FLAMINGO RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-6464
Country : US
Telephone Number : 719-237-0749
Fax Number :
Provider Business Practice Location Address
First Line : 9183 W FLAMINGO RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-6464
Country : US
Telephone Number : 702-650-6508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2015
Last Update Date : 01/08/2015

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Directions to “ CELESTE GOSHORN ” Practice Location

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