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Organization
EQUANIMITY BEHAVIORAL SERVICES CO
Active
Organization
EQUANIMITY BEHAVIORAL SERVICES CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY DAYANA NEGRON D.H.SCI, ITDS (PRESIDENT)
(650) 213-2283
Entity
Organization
Contact information
Practice address
14359 MIRAMAR PKWY, SUITE 504, MIRAMAR, FL 33027
(650) 213-2283
Mailing address
14359 MIRAMAR PKWY STE 504, MIRAMAR, FL 33027-4134
(650) 213-2283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024772100
—
FL
Enumeration date
09/13/2017
Last updated
07/21/2022
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