Provider Demographics
NPI:1033136890
Name:AQUILINA, DANIEL E
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:AQUILINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 9TH ST
Mailing Address - Street 2:#21
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1598
Mailing Address - Country:US
Mailing Address - Phone:641-919-6435
Mailing Address - Fax:
Practice Address - Street 1:507 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-5115
Practice Address - Country:US
Practice Address - Phone:319-338-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA059881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical