Provider Demographics
NPI:1134799703
Name:MCLAWHORN, TARAVIA (CCC)
Entity type:Individual
Prefix:
First Name:TARAVIA
Middle Name:
Last Name:MCLAWHORN
Suffix:
Gender:
Credentials:CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16403 HOLLY CREST LN APT 106
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5108
Mailing Address - Country:US
Mailing Address - Phone:336-588-5514
Mailing Address - Fax:
Practice Address - Street 1:637 TOYOTA DR
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-7129
Practice Address - Country:US
Practice Address - Phone:336-588-5514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14954235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist