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NPI 1104774736

NPI 1104774736 : EQUILIBRUM BEHAVIORAL HEALTH &T ELEPSYCH : OWINGS MILLS, MD

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General NPI Number Information
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    NPI Number           |    1104774736
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    Entity Type          |    Organization 
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    Legal Business Name  |    EQUILIBRUM BEHAVIORAL HEALTH &T ELEPSYCH 
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Dates
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    Enumeration Date     |    03/19/2026
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    Last Update Date     |    03/19/2026
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Provider Practice Location Address
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    Address Line         |    2307 SHADED BROOK DR 
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    City                 |    OWINGS MILLS
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    State                |    MD
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    Zip                  |    21117-2349
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    Country              |    US
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    Telephone            |    916-527-4740
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2307 SHADED BROOK DR 
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    City                 |    OWINGS MILLS
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    State                |    MD
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    Zip                  |    21117-2349
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ONWER
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    Name                 |    MRS. BEATRICE  GILZINE-BBACKWOOD 
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    Credential           |    NP
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    Telephone            |    916-527-4740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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