Provider Demographics
NPI:1861920555
Name:EQUULIBRIUM INTERNATIONAL INC.
Entity type:Organization
Organization Name:EQUULIBRIUM INTERNATIONAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:954-661-8586
Mailing Address - Street 1:18130 SW 50TH CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1024
Mailing Address - Country:US
Mailing Address - Phone:954-661-8586
Mailing Address - Fax:
Practice Address - Street 1:18130 SW 50TH CT
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1024
Practice Address - Country:US
Practice Address - Phone:954-661-8586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6088103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651001211OtherGISELLE FAUBEL, PSY.D.