Provider Demographics
NPI:1194155432
Name:WEE TALK SPEECH-LANGUAGE SERVICES
Entity type:Organization
Organization Name:WEE TALK SPEECH-LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:TIBBETTS-OSSO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:540-809-0661
Mailing Address - Street 1:11413 CHANCELLOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8419
Mailing Address - Country:US
Mailing Address - Phone:540-809-0661
Mailing Address - Fax:540-786-0625
Practice Address - Street 1:11413 CHANCELLOR PARK DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8419
Practice Address - Country:US
Practice Address - Phone:540-809-0661
Practice Address - Fax:540-786-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002820235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty