Provider Demographics
NPI:1528199189
Name:WEE, J. LYNNETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:J. LYNNETTE
Middle Name:
Last Name:WEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 W FERRY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1605
Mailing Address - Country:US
Mailing Address - Phone:716-886-3389
Mailing Address - Fax:716-886-3814
Practice Address - Street 1:677 W FERRY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1605
Practice Address - Country:US
Practice Address - Phone:716-886-3389
Practice Address - Fax:716-886-3814
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009944-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical