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Organization
EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS LLC
Active
Organization
EQUANIMITY INTEGRATED BEHAVIORAL HEALTH & WELLNESS LLC
Active
Other names
Equanimity: IBHW
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD E DEGRAFENREID II PMHNP-BC (OWNER/CEO)
(410) 240-1162
Entity
Organization
Contact information
Practice address
7500 HARFORD RD STE 1, PARKVILLE, MD 21234-6900
(410) 240-1162
Mailing address
7500 HARFORD RD STE 1, PARKVILLE, MD 21234-6900
(410) 240-1162
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/21/2020
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