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General NPI Number Information
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NPI Number | 1720603897
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Entity Type | Organization
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Legal Business Name | EQUINIMITY, LLC
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Dates
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Enumeration Date | 06/14/2020
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Last Update Date | 06/14/2020
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Provider Practice Location Address
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Address Line | 60330 RIMFIRE RD
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City | BEND
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State | OR
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Zip | 97702-9236
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Country | US
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Telephone | 541-797-4516
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Fax |
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Provider Business Mailing Address
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Address Line | 60330 RIMFIRE RD
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City | BEND
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State | OR
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Zip | 97702-9236
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Country | US
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Telephone | 541-797-4516
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Fax |
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Authorized Official
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Title or Position | OWNER/MARRIAGE AND FAMILY THERAPIST
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Name | MRS. ROMINA FRIDA KING
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Credential | M.A., LMFT, CEIP-MH
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Telephone | 541-797-4516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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