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Organization

EQUILIBRIUM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDY K GRAHAM EDS LPC (LICENSED PROFESSIONAL COUNSELOR)
18033613066
Entity
Organization

Contact information

Practice address
701 GERVAIS ST, STE 150-258, COLUMBIA, SC 29201-3066
(803) 361-3066
(866) 834-4286
Mailing address
1821 PICKENS ST, COLUMBIA, SC 29201-2630
(803) 361-3066
(866) 834-4286

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4644
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1730137456
NPI LPC
SC
Enumeration date
04/23/2007
Last updated
08/22/2020
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