Provider Demographics
NPI:1275923468
Name:FARLEY, MARLENA J (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARLENA
Middle Name:J
Last Name:FARLEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 N HOSPITAL DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4800
Mailing Address - Country:US
Mailing Address - Phone:803-791-2828
Mailing Address - Fax:803-791-2824
Practice Address - Street 1:146 N HOSPITAL DR
Practice Address - Street 2:SUITE 430
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4800
Practice Address - Country:US
Practice Address - Phone:803-791-2828
Practice Address - Fax:803-791-2824
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC832133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered