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General NPI Number Information
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NPI Number | 1366169393
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Entity Type | Organization
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Legal Business Name | EQUILIBRIO, LLC.
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | CARR. 123 KM 36.6 INT 522 KM 0.2 BO. GARZAS
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City | ADJUNTAS
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State | PR
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Zip | 00601-0060
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Country | US
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Telephone | 787-360-4565
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1868
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City | ARECIBO
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State | PR
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Zip | 00613-1868
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Country | US
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Telephone | 787-624-3880
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Fax |
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Authorized Official
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Title or Position | PSICOLOGA CLINICA
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Name | DR. FABIOLA P NAJUL SEDA
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Credential | PHD
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Telephone | 787-360-4565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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