Provider Demographics
NPI:1013731868
Name:DARGAJ, STEPHEN D
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:DARGAJ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E DUBLIN GRANVILLE RD STE G
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3183
Mailing Address - Country:US
Mailing Address - Phone:614-844-3800
Mailing Address - Fax:
Practice Address - Street 1:1200 VALLEY BELT RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44131-1437
Practice Address - Country:US
Practice Address - Phone:440-539-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1811249106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician