Provider Demographics
NPI:1922830934
Name:LOGGIE, KATIE (MS, RDN, CDCES, CNSC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:LOGGIE
Suffix:
Gender:F
Credentials:MS, RDN, CDCES, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 TOBACCO MILL ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3835
Mailing Address - Country:US
Mailing Address - Phone:845-304-7803
Mailing Address - Fax:
Practice Address - Street 1:2025 TOBACCO MILL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-3835
Practice Address - Country:US
Practice Address - Phone:845-304-7803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008586-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered