Organization
KIDABILITIES PEDIATRIC THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH S ROARK SLP (SLP/OWNER)
(606) 545-2631
Entity
Organization
Contact information
Practice address
2801 US HIGHWAY 25 E, SUITE 98, MIDDLESBORO, KY 40965-2069
(606) 545-2631
Mailing address
535 J GOODIN BRANCH RD, BARBOURVILLE, KY 40906-8159
(606) 545-2631
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
KY
235Z00000X
Speech-Language Pathologist
—
KY
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
05/17/2023
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