Provider Demographics
NPI:1508634239
Name:FARLEY, AISLINN NICOLE
Entity Type:Individual
Prefix:
First Name:AISLINN
Middle Name:NICOLE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 RUTLEDGE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-4691
Mailing Address - Country:US
Mailing Address - Phone:551-427-9170
Mailing Address - Fax:
Practice Address - Street 1:222 RED BANK RD
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-4502
Practice Address - Country:US
Practice Address - Phone:843-628-2935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician