Healthcare Provider Details

I. General information

NPI: 1992874820
Provider Name (Legal Business Name): ELAINE B. HOBSON M.S., C.C.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 SE 4
LEXINGTON OK
73051-1067
US

IV. Provider business mailing address

PO BOX 1067
LEXINGTON OK
73051-1067
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-5929
  • Fax: 405-527-9484
Mailing address:
  • Phone: 405-527-5929
  • Fax: 405-527-9484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number212
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: