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General NPI Number Information
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NPI Number | 1467057646
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Entity Type | Individual
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Provider Name | ANNA ELISE WORTHINGTON
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 608 N ELEAZAR AVE
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City | KAPLAN
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State | LA
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Zip | 70548-2926
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Country | US
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Telephone | 337-643-7965
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Fax |
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Provider Business Mailing Address
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Address Line | 220 S JEFFERSON ST
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City | ABBEVILLE
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State | LA
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Zip | 70510-5906
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Country | US
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Telephone | 337-893-3973
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8559
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License Number State | LA
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