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General NPI Number Information
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NPI Number | 1588393839
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Entity Type | Individual
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Provider Name | ANJOLI M AISENBREY BSPN, MSSW
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 6505 216TH ST SW STE 100
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2089
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Country | US
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Telephone | 425-640-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 8247 HICKORY HOLLOW DR
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City | GLEN BURNIE
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State | MD
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Zip | 21060-8721
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Country | US
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Telephone | 424-477-4768
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61650301
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License Number State | WA
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