MEDICARE: TIA ANITRA MCKNIGHT M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2915	TN
2	235Z00000X	Speech-Language Pathologist	4795	SC
3	235Z00000X	Speech-Language Pathologist	7335	NC

General Provider Information

NPI Number	:	1003103144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIA ANITRA MCKNIGHT M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	929 AZURINE CIR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-9326
Country	:	US
Telephone Number	:	931-205-7669
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 AZURINE CIR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-9326
Country	:	US
Telephone Number	:	931-205-7669
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	05/01/2025

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Directions to “ TIA ANITRA MCKNIGHT M.S., CCC-SLP” Practice Location

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