Provider Information for 1306445309
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Mrs. TERESA NICOLE WORTHY LPC
Sex: Female
NPI: 1306445309
Last Updated: 2020-10-21
Certification Date: 2020-10-21
Certification Date: 2020-10-21
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1306445309 | ||||||||
| Enumeration Date | 2020-10-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6690 ROSE LN # B MARION, MS 39342-9201 United States Phone: 601-479-6474 | Fax: | ||||||||
| Primary Practice Address | 6690 ROSE LN # B MARION, MS 39342-9201 United States Phone: 601-479-6474 | Fax: | ||||||||
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