Provider Demographics
NPI:1457077869
Name:JOLIE, ANAIA LEILANI KEALI'I
Entity type:Individual
Prefix:DR
First Name:ANAIA
Middle Name:LEILANI KEALI'I
Last Name:JOLIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 N POINT DR # 1195
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8266
Mailing Address - Country:US
Mailing Address - Phone:943-241-6433
Mailing Address - Fax:
Practice Address - Street 1:945 N POINT DR # 1195
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8266
Practice Address - Country:US
Practice Address - Phone:678-878-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LMFT002100102L00000X
GALMFT002100106H00000X
WALF61438733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst