Doctor Name: | JANIE M POPOUR-HOGUE |
NPI Number: | 1134353808 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 326 |
Business Practice Address: | 24919 S 4420 Rd Vinita, OK - 743015529 |
Business Phone Number: | 9182569120 |
Business Fax Number: | 9182566377 |
Mailing Address: | 24919 S 4420 Rd, VINITA |
State: | OK |
Postal Code: | 743015529 |
Phone Number: | 9182569120 |
Fax Number: | 9182566377 |
NPI Enumeration Date: | 05/11/2009 |
NPI Last Update Date: | 05/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |