Individual
DENNIS WEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 DATURA ST STE 414, WEST PALM BEACH, FL 33401-5632
(561) 707-6311
Mailing address
224 DATURA ST STE 414, WEST PALM BEACH, FL 33401-5632
(561) 707-6311
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY3680
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY 3680
FL
222Q00000X
Developmental Therapist
PY3680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810932000
—
FL
Enumeration date
04/19/2007
Last updated
05/07/2019
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