Individual
AMANDA GORDILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RD, LD
Contact information
Practice address
2304 TRAILRIDGE S, MISHAWAKA, IN 46544-6624
(574) 383-3542
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86015474
IN
Other
Enumeration date
05/15/2018
Last updated
12/08/2021
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