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General NPI Number Information
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NPI Number | 1891631156
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Entity Type | Organization
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Legal Business Name | COASTAL SPEECH AND LANGUAGE CENTER, LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 1439 N US HIGHWAY 1 STE A6
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City | ORMOND BEACH
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State | FL
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Zip | 32174-0736
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Country | US
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Telephone | 386-450-8083
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Fax | 386-777-3863
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Provider Business Mailing Address
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Address Line | 1439 N US HIGHWAY 1 STE A6
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City | ORMOND BEACH
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State | FL
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Zip | 32174-0736
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Country | US
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Telephone | 386-450-8083
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Fax | 386-777-3863
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | JENNIFER DUCKWORTH
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Credential | MS, CCC-SLP
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Telephone | 386-346-0523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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