Provider Demographics
NPI:1861060790
Name:EQWELL
Entity type:Organization
Organization Name:EQWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DESROSIERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:203-561-6798
Mailing Address - Street 1:1555 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5671
Mailing Address - Country:US
Mailing Address - Phone:203-561-6798
Mailing Address - Fax:
Practice Address - Street 1:1555 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5671
Practice Address - Country:US
Practice Address - Phone:203-561-6798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty