Individual
EKARADHIKA LILA REQUENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 10TH ST SW, WAVERLY, IA 50677-2925
(319) 352-2064
(319) 352-2329
Mailing address
111 10TH ST SW, WAVERLY, IA 50677-2925
(319) 352-2064
(319) 352-2329
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
079124
IA
Other
Enumeration date
09/09/2015
Last updated
12/20/2023
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