MEDICARE: MS. BONNIE LOVETT MHR LPC UNDER SUPERV

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1063552081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIE LOVETT MHR LPC UNDER SUPERV

Provider Business Mailing Address
First Line	:	10325 GREENBRIAR PL STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7647
Country	:	US
Telephone Number	:	405-378-3866
Fax Number	:	405-759-3867

Provider Business Practice Location Address
First Line	:	10325 GREENBRIAR PL STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7647
Country	:	US
Telephone Number	:	405-378-3866
Fax Number	:	405-759-3867

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	03/01/2018

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