Individual
MICHELLE R GHOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LMHC, LPC
Contact information
Practice address
502 E. BOONE AVE, AD 25, WASHINGTON, WA 99206-0025
(509) 313-3848
(509) 313-5964
Mailing address
502 E. BOONE AVE, AD 25, WASHINGTON, WA 99206-0025
(509) 313-3848
(509) 313-5964
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004092
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945441
—
VA
01
—
269384
ANTHEM BLUE SHIELD
VA
Enumeration date
01/03/2007
Last updated
03/17/2014
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