Individual
ELEONORA TATASHADZE
Active
Individual
ELEONORA TATASHADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PROVIDER
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
0000493
CT
171WH0202X
Home Modifications Contractor
Primary
4203630
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4203630
STATE OF OHIO CERTIFICATE
OH
Enumeration date
04/28/2011
Last updated
12/24/2020
Update your record
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