Provider Demographics
NPI:1801184320
Name:GARONE, DOROTHY LYNN (MS,RD,CFCS,LRD)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:LYNN
Last Name:GARONE
Suffix:
Gender:F
Credentials:MS,RD,CFCS,LRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1619
Mailing Address - Country:US
Mailing Address - Phone:803-397-1491
Mailing Address - Fax:
Practice Address - Street 1:2709 CLARK STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4024
Practice Address - Country:US
Practice Address - Phone:803-397-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC822133N00000X, 133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education