NPI 1548613425 · live from the CMS NPI Registry
Raphael Bonelle
Behavior Analyst in Oklahoma City, OK. National Provider Identifier 1548613425, active.
NPI record
| NPI | 1548613425 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 12000 N Virginia Ave, Oklahoma City, OK 73120 |
| Practice phone | 405-835-6757 |
| Mailing address | 5924 Sw 12th St, Apt 5304, Oklahoma City, OK 73128 |
| Enumerated | July 15, 2016 |
| Last updated | July 15, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 308629 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.