Provider Demographics
NPI:1407197155
Name:POGI, TABITHA T
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:T
Last Name:POGI
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 1:6807 SW OAKLAND LN
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5018
Mailing Address - Country:US
Mailing Address - Phone:580-647-9532
Mailing Address - Fax:
Practice Address - Street 1:6807 SW OAKLAND LN
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5018
Practice Address - Country:US
Practice Address - Phone:580-647-9532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor