Healthcare Provider Details
I. General information
NPI: 1669934261
Provider Name (Legal Business Name): THE EQUINE HEALING COLLABORATIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2019
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8767 CARMEL VALLEY RD
CARMEL CA
93923-7958
US
IV. Provider business mailing address
PO BOX 1087
MONTEREY CA
93942-1087
US
V. Phone/Fax
- Phone: 831-582-1017
- Fax:
- Phone: 831-582-1017
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
FENTON
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 831-582-1017