Individual
DR. GREGORY JOHN WORTHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
401 W FRONT ST, SUITE #3, TRAVERSE CITY, MI 49684-2259
(231) 932-0232
(231) 932-0232
Mailing address
401 W FRONT ST, SUITE #3, TRAVERSE CITY, MI 49684-2259
(231) 932-0232
(231) 932-0232
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012248
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OB81123
BLUE CROSS BLUE SHIELD PIN
MI
Enumeration date
05/21/2009
Last updated
05/21/2009
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