# FIRM FOUNDATION PEDIATRIC THER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376216788
- **Authorized official:** DR. KIMBERLY A ROACH DPT (OWNER)
- **Authorized official phone:** (318) 224-9081

## Contact information

- **Practice address:** 1316 E KENTUCKY AVE, RUSTON, LA 71270-6609
- **Practice address phone:** (318) 224-9081
- **Mailing address:** 683 ROACH RD, CHOUDRANT, LA 71227-3630
- **Mailing address phone:** (318) 918-0756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235500000X | Speech/Language/Hearing Specialist/Technologist | — | NULL | Yes |
| 235500000X | Speech/Language/Hearing Specialist/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2021
- **Last updated:** 07/26/2023