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Individual

MRS. JESSICA JOHANNA NALANI WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
87-135 PUALEILANI ST, WAIANAE, HI 96792-3697
(808) 207-0637
(626) 565-2087
Mailing address
PO BOX 13056, AIEA, HI 96701-8556
(808) 207-0637

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-4450
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
800221
HI
Enumeration date
07/29/2019
Last updated
09/05/2024
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