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Individual

JESSIE LOU POAHWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
615 N MAIN ST, ALTUS, OK 73521-3111
(580) 471-1855
Mailing address
1332 N THOMAS ST APT 14, ALTUS, OK 73521-2852
(580) 318-0654

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
Primary

Other

Enumeration date
02/27/2023
Last updated
05/02/2025
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