Provider Demographics
NPI:1104323187
Name:FRAYLON, TAYONA LANIA
Entity type:Individual
Prefix:
First Name:TAYONA
Middle Name:LANIA
Last Name:FRAYLON
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 1:325 MATTHEWS MINT HILL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-0004
Mailing Address - Country:US
Mailing Address - Phone:704-350-5837
Mailing Address - Fax:704-936-0428
Practice Address - Street 1:325 MATTHEWS MINT HILL RD STE 210
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-0004
Practice Address - Country:US
Practice Address - Phone:704-350-5837
Practice Address - Fax:704-936-0428
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NC13729101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251S00000XAgenciesCommunity/Behavioral Health