Doctor Name: | MS. ASHLEY WIBERG |
NPI Number: | 1841590684 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W |
License Number: | |
Business Practice Address: | 56-660 Kamehameha Hwy Kahuku, HI - 967312210 |
Business Phone Number: | 8082937555 |
Business Fax Number: | |
Mailing Address: | 55-690 Wahinepee St. C, LAIE |
State: | WA |
Postal Code: | 96762 |
Phone Number: | 5095512750 |
Fax Number: | |
NPI Enumeration Date: | 10/27/2010 |
NPI Last Update Date: | 10/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |