Provider Demographics
NPI:1821708405
Name:EATPLAYCONNECT LLC
Entity Type:Organization
Organization Name:EATPLAYCONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-687-2387
Mailing Address - Street 1:S4202 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-8108
Mailing Address - Country:US
Mailing Address - Phone:414-687-2387
Mailing Address - Fax:
Practice Address - Street 1:S4202 WHISPERING PINES DR
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-8108
Practice Address - Country:US
Practice Address - Phone:414-687-2387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty