Individual
EBONY GHOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 OLIVE ST STE 500, SAINT LOUIS, MO 63103-2377
(314) 250-1557
Mailing address
1430 OLIVE ST STE 500, SAINT LOUIS, MO 63103-2377
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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