| NPI | 1013561976 |
|---|---|
| Doing Business As | EQUANIMITY: IBHW |
| Entity Type | Organization |
| Authorized Contact | REGINALD E DEGRAFENREID Owner/CEO 410-240-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2020-07-21 |