Healthcare Provider Details

I. General information

NPI: 1194469262
Provider Name (Legal Business Name): KAYLA NICOLE LOVING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5265 S BUSINESS HIGHWAY 71
PINEVILLE MO
64856-8505
US

IV. Provider business mailing address

405 E EXCELSIOR AVE
VINITA OK
74301-4226
US

V. Phone/Fax

Practice location:
  • Phone: 417-223-4290
  • Fax: 417-223-4299
Mailing address:
  • Phone: 918-256-6476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: