Individual
TISHA GATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2406 AUTUMN OAK CT, CHAMPAIGN, IL 61822-7647
(217) 766-2650
Mailing address
2406 AUTUMN OAK CT, CHAMPAIGN, IL 61822-7647
(217) 766-2650
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
IL
374J00000X
Doula
Primary
—
—
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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