Healthcare Provider Details
I. General information
NPI: 1063343341
Provider Name (Legal Business Name): PLAYCONNECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43507 N IRONWOOD DR
SAN TAN VALLEY AZ
85140-9312
US
IV. Provider business mailing address
4124 S SAWMILL RD
GILBERT AZ
85297-3079
US
V. Phone/Fax
- Phone: 480-331-2256
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDSAY
NOWAKOWSKI
Title or Position: BEHAVIOR ANALYST
Credential: BCBA, LBA
Phone: 480-331-2256