Provider Demographics
NPI:1598452963
Name:WORTHINGTON, AMBER FAITH
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:FAITH
Last Name:WORTHINGTON
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 1:3637 CLINEDALE RD
Mailing Address - Street 2:
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-9309
Mailing Address - Country:US
Mailing Address - Phone:336-837-4797
Mailing Address - Fax:336-376-7711
Practice Address - Street 1:2990 BETHESDA PL STE 604D
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3315
Practice Address - Country:US
Practice Address - Phone:336-837-4797
Practice Address - Fax:336-376-7711
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist