Healthcare Provider Details

I. General information

NPI: 1841103207
Provider Name (Legal Business Name): EAT TALK LIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 BAYSIDE RD UNIT 205
CHESAPEAKE BEACH MD
20732-3352
US

IV. Provider business mailing address

8501 BAYSIDE RD UNIT 205
CHESAPEAKE BEACH MD
20732-3352
US

V. Phone/Fax

Practice location:
  • Phone: 301-818-2518
  • Fax:
Mailing address:
  • Phone: 301-818-2518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LISA CARYL WEISS
Title or Position: OWNER
Credential: M.A.,CCC-SLP
Phone: 301-785-2954