Individual
TAHLOR E MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTD
Contact information
Practice address
15774 S LA GRANGE RD STE 272, ORLAND PARK, IL 60462-4766
(312) 478-2144
Mailing address
76 BRENNER CT, LYNWOOD, IL 60411-4623
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
193200000X
IL
174N00000X
Lactation Consultant (Non-RN)
193200000X
IL
374J00000X
Doula
193200000X
IL
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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