Provider Demographics
NPI:1568169852
Name:WORTHAM, ANDREA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WORTHAM
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 1:2834 ALMESTER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7603
Mailing Address - Country:US
Mailing Address - Phone:513-560-9624
Mailing Address - Fax:513-389-1605
Practice Address - Street 1:2834 ALMESTER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7603
Practice Address - Country:US
Practice Address - Phone:513-560-9624
Practice Address - Fax:513-389-1605
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist