MEDICARE: RAPHAEL BONELLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	308629	OK

General Provider Information

NPI Number	:	1548613425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAPHAEL BONELLE

Provider Business Mailing Address
First Line	:	5924 SW 12TH ST
Second Line	:	APT 5304
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73128-5900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12000 N VIRGINIA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-7581
Country	:	US
Telephone Number	:	405-835-6757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2016
Last Update Date	:	07/15/2016

Similar Medicare Providers

1447794011 — MELISSA NICHOLE OTTO PPS
Practice Location Address:

12000 N VIRGINIA AVE
OKLAHOMA CITY, OK
73120-7581

Practice Phone: 405-835-6757
Practice Fax: 405-213-1628

1487199246 — RICKEY HOUSE
Practice Location Address:

12000 N VIRGINIA AVE
OKLAHOMA CITY, OK
73120-7581

Practice Phone: 405-835-6757
Practice Fax:

1295421709 — LOVE GROW LIVE CENTER, INC
Practice Location Address:

12000 N VIRGINIA AVE
OKLAHOMA CITY, OK
73120-7581

Practice Phone: 405-315-9790
Practice Fax:

1174202485 — AMANDA GAIL HENRY APRN-CNS
Practice Location Address:

4120 W MEMORIAL RD STE 300
OKLAHOMA CITY, OK
73120-9322

Practice Phone: 405-302-2661
Practice Fax: 405-302-2670

1477167534 — MRS. MARY E M SCRUGGS LMFT
Practice Location Address:

10400 VINEYARD BLVD STE A
OKLAHOMA CITY, OK
73120-3830

Practice Phone: 405-242-5305
Practice Fax:

1649535915 — DR. ANAND KUMAR MD
Practice Location Address:

4200 W MEMORIAL RD STE 310
OKLAHOMA CITY, OK
73120-8378

Practice Phone: 405-749-7014
Practice Fax: 405-749-7024

Directions to “ RAPHAEL BONELLE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.