Healthcare Provider Details

I. General information

NPI: 1730228537
Provider Name (Legal Business Name): TARRA A HARDIN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 GATEWAY RD UNIT B
MYRTLE BEACH SC
29579-5400
US

IV. Provider business mailing address

3974 LARK HILL DR
MYRTLE BEACH SC
29577-5880
US

V. Phone/Fax

Practice location:
  • Phone: 843-796-3964
  • Fax:
Mailing address:
  • Phone: 910-740-5815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4157
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2689
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: