MEDICARE: PLAYLAB COLLECTIVE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist
3	101YP2500X	Professional Counselor
4	235Z00000X	Speech-Language Pathologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912896275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAYLAB COLLECTIVE, INC

Provider Business Mailing Address
First Line	:	2335 S GREEN BAY RD
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53406-4921
Country	:	US
Telephone Number	:	262-497-7270
Fax Number	:	877-540-0135

Provider Business Practice Location Address
First Line	:	5300 S 76TH ST
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-1102
Country	:	US
Telephone Number	:	262-497-7270
Fax Number	:	877-540-0135

Authorized Official
Title or Position	:	OWNER
Name	:	TAMMY MYERS
Credential	:	MS CCC SLP
Telephone Number	:	262-721-7357

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	02/12/2026

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Directions to “PLAYLAB COLLECTIVE, INC ” Practice Location

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