MEDICARE: CHRISTINA LEA AQUINO LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	008216	IA
2	104100000X	Social Worker	008216	IA

General Provider Information

NPI Number	:	1215307111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LEA AQUINO LISW

Provider Business Mailing Address
First Line	:	4314 HOLLY CIR NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52411-4726
Country	:	US
Telephone Number	:	641-781-0538
Fax Number	:

Provider Business Practice Location Address
First Line	:	4403 1ST AVE SE STE 416
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3221
Country	:	US
Telephone Number	:	641-781-0538
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2015
Last Update Date	:	02/09/2026

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