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General NPI Number Information
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NPI Number | 1194155432
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Entity Type | Organization
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Legal Business Name | WEE TALK SPEECH-LANGUAGE SERVICES
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 11413 CHANCELLOR PARK DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-8419
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Country | US
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Telephone | 540-809-0661
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Fax | 540-786-0625
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Provider Business Mailing Address
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Address Line | 11413 CHANCELLOR PARK DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-8419
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Country | US
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Telephone | 540-809-0661
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Fax | 540-786-0625
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. LISA B. TIBBETTS-OSSO
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Credential | CCC-SLP
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Telephone | 540-809-0661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202002820
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License Number State | VA
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