Provider Demographics
NPI:1700079845
Name:WEE ALONG PLAY THERAPY
Entity Type:Organization
Organization Name:WEE ALONG PLAY THERAPY
Other - Org Name:WEE ALONG PLAY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-476-2276
Mailing Address - Street 1:1164 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-9794
Mailing Address - Country:US
Mailing Address - Phone:910-476-2276
Mailing Address - Fax:
Practice Address - Street 1:1164 NORTON RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-9794
Practice Address - Country:US
Practice Address - Phone:910-476-2276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302019Medicaid