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General NPI Number Information
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NPI Number | 1194869289
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Entity Type | Individual
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Provider Name | TASHA NICOLE WORTHY
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1085 VICTORIA AVE.
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City | COMPTON
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State | CA
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Zip | 90220
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Country | US
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Telephone | 310-221-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W LOUISE ST
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City | LONG BEACH
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State | CA
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Zip | 90805-5212
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Country | US
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Telephone | 562-984-0377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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