Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1473 | NC |
Y | 103T00000X | Psychologist | 1473 | NC |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1473 | NC |
N | 103TC1900X | Counseling Psychologist | 1473 | NC |
N | 103TF0000X | Family Psychologist | 1473 | NC |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1473 | NC |
NPI | 1023388618 |
---|---|
Provider Name | Ms. Sandra Joyce Worthington |
First Address | Hickory, NC 28602-1364 |
Second Address | Hickory, NC 28602-1364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2012 |
Last Update Date | 17/03/2018 |