Provider Demographics
NPI:1033608757
Name:DARGIE, KATIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:DARGIE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:ME
Mailing Address - Zip Code:04055-5437
Mailing Address - Country:US
Mailing Address - Phone:207-240-9387
Mailing Address - Fax:
Practice Address - Street 1:161 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:ME
Practice Address - Zip Code:04055-5437
Practice Address - Country:US
Practice Address - Phone:207-240-9387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst