MEDICARE: KATIE LOVE

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	106H00000X	Marriage & Family Therapist	135004	CA

General Provider Information

NPI Number	:	1568962264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE LOVE

Provider Business Mailing Address
First Line	:	629 W MAIN ST # 1021
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-2221
Country	:	US
Telephone Number	:	619-500-7078
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 W MAIN ST # 1021
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-2221
Country	:	US
Telephone Number	:	619-500-7078
Fax Number	:

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

Provider Enumeration Date	:	02/19/2018
Last Update Date	:	11/18/2024

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Directions to “ KATIE LOVE ” Practice Location

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