Provider Demographics
NPI:1588776702
Name:NIINIKOSKI, JAANA (PHD)
Entity type:Individual
Prefix:
First Name:JAANA
Middle Name:
Last Name:NIINIKOSKI
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 1:2110 MCFARLAND BLVD EAST
Mailing Address - Street 2:SUITE F
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404
Mailing Address - Country:US
Mailing Address - Phone:205-758-7710
Mailing Address - Fax:205-758-3969
Practice Address - Street 1:2110 MCFARLAND BLVD EAST
Practice Address - Street 2:SUITE F
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404
Practice Address - Country:US
Practice Address - Phone:205-758-7710
Practice Address - Fax:205-758-3969
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical