Provider Demographics
NPI:1851647770
Name:WEE PLAYTHERAPY PLLC
Entity Type:Organization
Organization Name:WEE PLAYTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMMERSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC- SLP
Authorized Official - Phone:239-674-9374
Mailing Address - Street 1:904 LEE BLVD
Mailing Address - Street 2:STE. 106
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4953
Mailing Address - Country:US
Mailing Address - Phone:239-674-9374
Mailing Address - Fax:239-491-3057
Practice Address - Street 1:904 LEE BLVD
Practice Address - Street 2:UNIT 106
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4953
Practice Address - Country:US
Practice Address - Phone:239-674-9374
Practice Address - Fax:239-790-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-29
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002444400Medicaid
FL006236000Medicaid
FL002444100Medicaid