Provider Demographics
NPI:1164210209
Name:DRAWHORN, CLARISSA M
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:M
Last Name:DRAWHORN
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 1:308 W SIGNODE RD
Mailing Address - Street 2:
Mailing Address - City:LATTA
Mailing Address - State:SC
Mailing Address - Zip Code:29565-4708
Mailing Address - Country:US
Mailing Address - Phone:843-773-0703
Mailing Address - Fax:
Practice Address - Street 1:308 W SIGNODE RD
Practice Address - Street 2:
Practice Address - City:LATTA
Practice Address - State:SC
Practice Address - Zip Code:29565-4708
Practice Address - Country:US
Practice Address - Phone:843-773-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care