Provider Demographics
NPI:1306128624
Name:POGUE, PAMELA GAYLE
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:GAYLE
Last Name:POGUE
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 1:617 2ND ST APT H1
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-9229
Mailing Address - Country:US
Mailing Address - Phone:918-798-1821
Mailing Address - Fax:
Practice Address - Street 1:330 W GRAY ST STE 140
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7118
Practice Address - Country:US
Practice Address - Phone:405-919-6821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker