Provider Demographics
NPI:1750648721
Name:WEE ACHIEVE THERAPY INC
Entity Type:Organization
Organization Name:WEE ACHIEVE THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER P
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC,SLP
Authorized Official - Phone:727-643-6148
Mailing Address - Street 1:12910 98TH AVENUE N.
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776
Mailing Address - Country:US
Mailing Address - Phone:727-643-6148
Mailing Address - Fax:727-954-3260
Practice Address - Street 1:12910 98TH AVENUE N.
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776
Practice Address - Country:US
Practice Address - Phone:727-643-6148
Practice Address - Fax:727-954-3260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SA5814235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004850800Medicaid