Organization
COASTAL KIDS SPEECH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH MALLEN MS, CCC-SLP (OWNER)
(561) 676-4213
Entity
Organization
Contact information
Practice address
772 SE WHITE AVE, PORT ST LUCIE, FL 34983-2672
(561) 676-4213
Mailing address
1158 SW HUNNICUT AVE, PORT ST LUCIE, FL 34953-5331
(561) 676-4213
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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