Healthcare Provider Details

I. General information

NPI: 1912877705
Provider Name (Legal Business Name): RACHEL LAUREN HOBSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N MAINE STREET
KINGFISHER OK
73750
US

IV. Provider business mailing address

1100 JEREMY ST
EL RENO OK
73036-4148
US

V. Phone/Fax

Practice location:
  • Phone: 580-356-9976
  • Fax:
Mailing address:
  • Phone: 405-227-0402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2505
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: