Individual
MRS. MELANIE RENEE KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1717 INDUSTRIAL DR, FORDYCE, AR 71742-7104
(870) 352-7975
Mailing address
1722 ABERNATHY ST, FORDYCE, AR 71742-2906
(870) 352-5033
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
858
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01090743
ASHA ACCOUNT NUMBER
AR
05
—
132032721
—
AR
01
—
SP #858
STATE LICENSURE
AR
Enumeration date
01/09/2007
Last updated
07/22/2011
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