Provider Demographics
NPI:1396060729
Name:STIGALL, JAYNEEN (PLPC)
Entity type:Individual
Prefix:MRS
First Name:JAYNEEN
Middle Name:
Last Name:STIGALL
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-0041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:406 N 4TH ST
Practice Address - Street 2:STE A
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-1152
Practice Address - Country:US
Practice Address - Phone:816-616-2812
Practice Address - Fax:888-779-8756
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010009133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional