Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | IL | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | IL | |
N | 103G00000X | Clinical Psychologist | IL | |
N | 103TC0700X | Clinical Psychologist | IL | |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | IL | |
N | 103TR0400X | Rehabilitation Psychologist | IL |
NPI | 1396797213 |
---|---|
Provider Name | Dr. Martin Allen Goldstein |
First Address | Skokie, IL 60076-3227 |
Second Address | Skokie, IL 60077-1389 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 08/07/2007 |