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General NPI Number Information
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NPI Number | 1699342568
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Entity Type | Individual
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Provider Name | ANNALISE EVELYN WISNIEWSKI M.ED
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Gender | Female
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 302 CALIFORNIA AVE STE 212
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City | WAHIAWA
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State | HI
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Zip | 96786-1841
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Country | US
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Telephone | 808-542-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 45-419 MOKULELE DR APT 1
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City | KANEOHE
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State | HI
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Zip | 96744-2110
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Country | US
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Telephone | 815-355-5169
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MHC-1096
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License Number State | HI
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