Healthcare Provider Details

I. General information

NPI: 1386226462
Provider Name (Legal Business Name): MICHAELA LOVEJOY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 S MAIN ST
GROVE OK
74344-5368
US

IV. Provider business mailing address

4245 S 188TH EAST AVE
TULSA OK
74134-7267
US

V. Phone/Fax

Practice location:
  • Phone: 918-557-4496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2025049883
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6280
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: