Provider Demographics
NPI:1669606307
Name:WORTHINGTON, LINDA KAY (SLP-CCC/L)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:SLP-CCC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22070 E 1900TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:61470-8424
Mailing Address - Country:US
Mailing Address - Phone:309-772-2867
Mailing Address - Fax:
Practice Address - Street 1:22070 E 1900TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE CITY
Practice Address - State:IL
Practice Address - Zip Code:61470-8424
Practice Address - Country:US
Practice Address - Phone:309-772-2867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist