Individual
DR. TASHANNA GILLENWATER
Active
Individual
DR. TASHANNA GILLENWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
3020440
IL
171400000X
Health & Wellness Coach
340416
IL
174H00000X
Health Educator
Primary
340416
IL
Other
Enumeration date
04/17/2023
Last updated
05/05/2023
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