Individual
BEVERLY DIANA GHOLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4130 HUNT PL NE, WASHINGTON, DC 20019-3565
(202) 388-4300
Mailing address
11806 LUSBYS LN, BRANDYWINE, MD 20613-7678
(301) 467-4626
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC301977
DC
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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