Provider Demographics
NPI:1326404229
Name:POE, KATHERINE (LADC/MH)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:POE
Suffix:
Gender:F
Credentials:LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4913 W RENO AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-6339
Mailing Address - Country:US
Mailing Address - Phone:405-948-4933
Mailing Address - Fax:
Practice Address - Street 1:5208 W RENO AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6344
Practice Address - Country:US
Practice Address - Phone:405-948-4900
Practice Address - Fax:405-948-4933
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor