Provider Demographics
NPI:1609673169
Name:SHOVLIN, KARA
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:SHOVLIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TUDOR OVAL
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2223
Mailing Address - Country:US
Mailing Address - Phone:908-456-3328
Mailing Address - Fax:
Practice Address - Street 1:1 TUDOR OVAL
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2223
Practice Address - Country:US
Practice Address - Phone:908-456-3328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach