Individual
JENNIFER GILLARDON-TARINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2314 BRINKLEY RD, JOHNS ISLAND, SC 29455-8336
(609) 509-0809
Mailing address
2314 BRINKLEY RD, JOHNS ISLAND, SC 29455-8336
(609) 509-0809
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00082800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029802504
NATABOC
SC
01
—
25MT00082800
STATE LICENSE #
NJ
Enumeration date
09/14/2022
Last updated
09/14/2022
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