| Poyner Psychological Services, Inc. | |
|
14453 Se 29th St Suite D Choctaw OK 73020-6541 | |
| (405) 741-2844 | |
| (405) 733-1334 |
| Full Name | Poyner Psychological Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 14453 Se 29th St, Choctaw, Oklahoma |
| Authorized Official Name and Position | Gail Anne Poyner (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4057412844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poyner Psychological Services, Inc. 14453 Se 29th St Suite B Choctaw OK 73020-6541 Ph: (405) 741-2844 | Poyner Psychological Services, Inc. 14453 Se 29th St Suite D Choctaw OK 73020-6541 Ph: (405) 741-2844 |
| NPI Number | 1457471765 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457471765 | NPI | - | NPPES |
| 200086310 A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 950 (Oklahoma) | Primary |
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