Organization
KELLY K'S SPEECH THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY IRENE KOPROVIC CCC-SLP (SPEECH PATHOLOGIST)
(479) 806-7440
Entity
Organization
Contact information
Practice address
102 N OAK ST, HACKETT, AR 72937-4756
(479) 806-7440
Mailing address
2208 LEE CREEK DR, VAN BUREN, AR 72956-6911
(479) 806-7440
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131677721
—
AR
Enumeration date
06/08/2020
Last updated
06/08/2020
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