Individual
MRS. KELLY IRENE KOPROVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2208 LEE CREEK DR, VAN BUREN, AR 72956-6911
(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
SP1270
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131677721
—
AR
Enumeration date
05/21/2007
Last updated
10/03/2018
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