Provider Demographics
NPI:1407589831
Name:FARHANE, FADOUA HILAL (RDN,LD)
Entity Type:Individual
Prefix:MRS
First Name:FADOUA
Middle Name:HILAL
Last Name:FARHANE
Suffix:
Gender:F
Credentials:RDN,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 WINDERMERE PARK CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6660
Mailing Address - Country:US
Mailing Address - Phone:470-908-2241
Mailing Address - Fax:
Practice Address - Street 1:580 WINDERMERE PARK CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-6660
Practice Address - Country:US
Practice Address - Phone:470-908-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86099332133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty