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General NPI Number Information
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NPI Number | 1457077869
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Entity Type | Individual
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Provider Name | DR. ANAIA LEILANI KEALI'I JOLIE
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Gender | Female
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 945 N POINT DR # 1195
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City | ALPHARETTA
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State | GA
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Zip | 30022-8266
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Country | US
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Telephone | 678-878-8227
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Fax |
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Provider Business Mailing Address
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Address Line | 945 N POINT DR # 1195
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City | ALPHARETTA
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State | GA
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Zip | 30022-8266
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Country | US
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Telephone | 943-241-6433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | LMFT002100
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT002100
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF61438733
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License Number State | WA
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