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Individual
KAITLYN SUPPA
Active
Individual
KAITLYN SUPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NULL
174400000X
Specialist
Primary
—
NULL
247200000X
Other Technician
—
ND
Other
Enumeration date
08/10/2018
Last updated
04/19/2023
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