Provider Demographics
NPI:1801230370
Name:WORTHAM, AMY CHRISTINE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CHRISTINE
Last Name:WORTHAM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2013
Mailing Address - Country:US
Mailing Address - Phone:615-446-2085
Mailing Address - Fax:615-441-4132
Practice Address - Street 1:115 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2013
Practice Address - Country:US
Practice Address - Phone:615-446-2085
Practice Address - Fax:615-441-4132
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist