Provider Demographics
NPI:1962262998
Name:DOLD, KATIE J
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:J
Last Name:DOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:J
Other - Last Name:WALTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:397 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-6807
Mailing Address - Country:US
Mailing Address - Phone:740-323-6308
Mailing Address - Fax:
Practice Address - Street 1:397 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6807
Practice Address - Country:US
Practice Address - Phone:740-323-6308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health