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Contact Information

KELLY KONOPACKI, PHD
500 FOOTHILL DR BLDG 3
SALT LAKE CITY, UT84148-0001
 Phone: 801-582-1565
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Neuropsychologist

103G00000X
Indicates primary specialty

NPI Profile & details for KELLY KONOPACKI · (Female)

NPI Number 1912362591
Status Active
Credentials PHD
Entity Individual
Enumeration date 12/23/2015
Last updated 12/13/2022 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 10299168-2501
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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