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General NPI Number Information
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NPI Number | 1639772502
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Entity Type | Organization
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Legal Business Name | EQUAFINALITY B
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 201 TYSON ST
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City | GREENVILLE
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State | NC
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Zip | 27834-1847
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Country | US
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Telephone | 252-864-9334
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1195
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City | BETHEL
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State | NC
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Zip | 27812-1195
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Country | US
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Telephone | 252-864-9334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEIRSTIN COTTO
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Credential | LCMHC, LCAS, CCS
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Telephone | 252-972-4357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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