| Fundamental Pediatric Therapy | |
|
128 Diane Lane Suite 4, Stonewall, LA 71078-9421 | |
| (318) 564-2171 | |
| Not Available |
| Full Name | Fundamental Pediatric Therapy |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 128 Diane Lane Suite 4, Stonewall, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962157719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Fundamental Pediatric Therapy 212 Panther Dr, Stonewall, LA 71078-9421 Ph: (318) 564-2171 | Fundamental Pediatric Therapy 128 Diane Lane Suite 4, Stonewall, LA 71078-9421 Ph: (318) 564-2171 |
Katie Bamburg, SLP-CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 834 Twin Oaks Rd, Stonewall, LA 71078 Phone: 318-990-0840 | |
Mrs. Faith Charrier, MS, L-SLP, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 128 Diane Ln Ste 4, Stonewall, LA 71078 Phone: 318-775-4164 | |
Michael Bagley Johnston, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 212 Panther Dr, Stonewall, LA 71078 Phone: 318-564-2171 | |
Mrs. Riley Eason Mcdaniel, MA/CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2535 Highway 171, Stonewall, LA 71078 Phone: 318-925-1610 Fax: 318-925-2970 | |
Katherine Deporter, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 128 Diane Lane, Suite 4, Stonewall, LA 71078 Phone: 219-771-6161 |