Organization
DR. WEISE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS MILTON WEISE PH.D. (PRESIDENT)
(561) 707-6311
Entity
Organization
Contact information
Practice address
224 DATURA ST STE 414, WEST PALM BEACH, FL 33401-5632
(561) 707-6311
Mailing address
PO BOX 8085, WEST PALM BEACH, FL 33407-0085
(561) 845-5524
(561) 845-0680
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
222Q00000X
Developmental Therapist
—
—
251S00000X
Community/Behavioral Health Agency
PY0003680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080937396
—
FL
Enumeration date
05/22/2007
Last updated
05/08/2019
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