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NPI Code Detail

MEDICARE: MISS LYDIA RUTH GOTSCHALL

MEDICARE: MISS LYDIA RUTH GOTSCHALL
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
1106S00000XBehavior TechnicianRBT-26-543499OK

General Provider Information

NPI Number : 1629902150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LYDIA RUTH GOTSCHALL
Provider Business Mailing Address
First Line : 3838 NW 36TH ST STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-2916
Country : US
Telephone Number : 405-702-9032
Fax Number : 405-702-9031
Provider Business Practice Location Address
First Line : 3838 NW 36TH ST STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-2916
Country : US
Telephone Number : 405-702-9032
Fax Number : 405-702-3031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ MISS LYDIA RUTH GOTSCHALL ” Practice Location

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