Provider Demographics
NPI:1932141439
Name:POYNER, GAIL ANNE
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:ANNE
Last Name:POYNER
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 1:14453 SE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-6530
Mailing Address - Country:US
Mailing Address - Phone:405-741-2844
Mailing Address - Fax:405-733-1334
Practice Address - Street 1:14453 SE 29TH ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-6530
Practice Address - Country:US
Practice Address - Phone:405-741-2844
Practice Address - Fax:405-733-1334
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK950103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling