Provider Demographics
NPI:1699978007
Name:OBADIAH, RACHEL DANIELLE
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:DANIELLE
Last Name:OBADIAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 S DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-3820
Mailing Address - Country:US
Mailing Address - Phone:918-853-6304
Mailing Address - Fax:
Practice Address - Street 1:117 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7602
Practice Address - Country:US
Practice Address - Phone:918-245-5565
Practice Address - Fax:918-245-5564
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor