Basic Information
Provider Information
NPI: 1285191221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOBE
FirstName: RACHAEL
MiddleName: HORIL
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HORIL
OtherFirstName: RACHAEL
OtherMiddleName: ELISE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1918 N MAIN ST
Address2:  
City: FINDLAY
State: OH
PostalCode: 458403818
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2515 N MAIN ST
Address2:  
City: FINDLAY
State: OH
PostalCode: 458403972
CountryCode: US
TelephoneNumber: 4194223711
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/26/2019
LastUpdateDate: 02/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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