Individual
SHAWN KISPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4313 S P ST, FORT SMITH, AR 72903-3103
(918) 649-0772
(918) 649-0071
Mailing address
4313 S P ST, FORT SMITH, AR 72903-3103
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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