Provider Demographics
NPI:1457658627
Name:NISKEY, MARINEZ
Entity Type:Individual
Prefix:
First Name:MARINEZ
Middle Name:
Last Name:NISKEY
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 1:1676 ALA MOANA BLVD
Mailing Address - Street 2:# 808
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1433
Mailing Address - Country:US
Mailing Address - Phone:808-772-3663
Mailing Address - Fax:
Practice Address - Street 1:606 CORAL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5135
Practice Address - Country:US
Practice Address - Phone:808-791-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health