Provider Demographics
NPI:1811656556
Name:ARGO, KATY BRYANA (MS, RDN, CNSC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:BRYANA
Last Name:ARGO
Suffix:
Gender:F
Credentials:MS, RDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 N 16TH ST UNIT 125
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1505
Mailing Address - Country:US
Mailing Address - Phone:480-395-6883
Mailing Address - Fax:
Practice Address - Street 1:6315 N 16TH ST UNIT 125
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1505
Practice Address - Country:US
Practice Address - Phone:480-395-6883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86059885133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered