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General NPI Number Information
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NPI Number | 1790635829
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Entity Type | Organization
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Legal Business Name | COASTAL PLAY & PROGRESS PLLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2032 EL JOBEAN RD UNIT 4
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1247
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Country | US
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Telephone | 941-237-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 11291 PINOT DR
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City | VENICE
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State | FL
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Zip | 34293-1799
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Country | US
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Telephone | 941-237-0017
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | NICHOLE BURNS
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Credential | CCC-SLP
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Telephone | 941-237-0017
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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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