Provider Demographics
NPI:1144873977
Name:BUSK, MICHELLE (MS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BUSK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:WASHBURN-BUSK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1506 BROWNING PL STE 107
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-7485
Mailing Address - Country:US
Mailing Address - Phone:785-539-5455
Mailing Address - Fax:
Practice Address - Street 1:1506 BROWNING PL STE 107
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-7485
Practice Address - Country:US
Practice Address - Phone:785-539-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2985106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist