Provider Demographics
NPI:1235287087
Name:NISKEY, JAYNE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAYNE
Middle Name:E
Last Name:NISKEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2572 HIGHWAY JJ
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63967-8110
Mailing Address - Country:US
Mailing Address - Phone:573-998-2807
Mailing Address - Fax:573-998-2390
Practice Address - Street 1:2572 HIGHWAY JJ
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63967-8110
Practice Address - Country:US
Practice Address - Phone:573-998-2807
Practice Address - Fax:573-998-2390
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000694101YP2500X
MO0020011041C0700X
MO300102106H00000X
CAMFC18491106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist