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General NPI Number Information
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NPI Number | 1346158680
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Entity Type | Organization
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Legal Business Name | COASTAL SPEECH THERAPY LLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 170 MAIN STREET P.O. BOX 272
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City | DAMARISCOTTA
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State | ME
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Zip | 04543
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Country | US
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Telephone | 207-240-4112
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Fax | 207-512-1564
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Provider Business Mailing Address
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Address Line | PO BOX 272
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-0272
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Country | US
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Telephone | 207-240-4112
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Fax | 207-512-1564
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER H BRYCE
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Credential | SLP
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Telephone | 207-240-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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