Individual
RICHARD E WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1225 S GEAR AVE, STE 252, WEST BURLINGTON, IA 52655-1691
(319) 768-3700
(319) 768-3712
Mailing address
PO BOX 540, WEST BURLINGTON, IA 52655-0540
(319) 768-3700
(319) 768-3712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00089
STATE LICENSE
IA
Enumeration date
07/03/2006
Last updated
07/08/2007
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