Healthcare Provider Details

I. General information

NPI: 1003750829
Provider Name (Legal Business Name): PEYTON BELLE KAEHLER I RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 E HALL OF FAME AVE STE 50
STILLWATER OK
74075-5414
US

IV. Provider business mailing address

406 E HALL OF FAME AVE STE 50
STILLWATER OK
74075-5414
US

V. Phone/Fax

Practice location:
  • Phone: 918-216-0242
  • Fax: 405-757-0727
Mailing address:
  • Phone: 918-216-0242
  • Fax: 405-757-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-529384
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: