Provider Demographics
NPI:1457679128
Name:POE, GALE (BHRS)
Entity Type:Individual
Prefix:MRS
First Name:GALE
Middle Name:
Last Name:POE
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 SW E AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-7320
Mailing Address - Country:US
Mailing Address - Phone:580-248-6450
Mailing Address - Fax:580-248-6426
Practice Address - Street 1:2501 SW E AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-7320
Practice Address - Country:US
Practice Address - Phone:580-248-6450
Practice Address - Fax:580-248-6426
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health