Healthcare Provider Details

I. General information

NPI: 1689582884
Provider Name (Legal Business Name): RACHEL POTTER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7711 E 111TH ST STE 111
TULSA OK
74133-2563
US

IV. Provider business mailing address

7711 E 111TH ST STE 111
TULSA OK
74133-2563
US

V. Phone/Fax

Practice location:
  • Phone: 918-928-5437
  • Fax: 888-720-8944
Mailing address:
  • Phone: 918-928-5437
  • Fax: 888-720-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13394
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: