Organization
EQUANIMITY COUNSELING AND PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANGELA PULIDO-BANNER PHD (OWNER/PSYCHOLOGIST)
(775) 553-0668
Entity
Organization
Contact information
Practice address
1462 US HIGHWAY 395 N, GARDNERVILLE, NV 89410-5203
(775) 553-0668
(775) 319-5922
Mailing address
6700 N LINDER RD, STE 156A, #331, MERIDIAN, ID 83646
(775) 553-0668
(775) 319-5922
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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