| Doctor Name: | DR. OFFIE WORTHAM |
| NPI Number: | 1184893042 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 0970001181 |
| Business Practice Address: | 136 N Main St Suite 2 Barre, VT - 056414170 |
| Business Phone Number: | 8024541419 |
| Business Fax Number: | 8024541419 |
| Mailing Address: | 136 N Main St, Suite 2 BARRE |
| State: | VT |
| Postal Code: | 056414170 |
| Phone Number: | 8024541419 |
| Fax Number: | 8024541419 |
| NPI Enumeration Date: | 02/25/2008 |
| NPI Last Update Date: | 02/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0970001181 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |