| NPI | 1932671682 |
|---|---|
| Former Name | KARA LOUISE SUPPES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MI 7501011321) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| 225800000X Recreation Therapist | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2024-03-15 |