Individual
JESSICA I FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, 120, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01062372
NC
Other
Enumeration date
09/20/2012
Last updated
02/03/2017
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