Provider Demographics
NPI:1407808835
Name:RAGSDALE, ISABELLE B (PH D)
Entity Type:Individual
Prefix:DR
First Name:ISABELLE
Middle Name:B
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-0477
Mailing Address - Country:US
Mailing Address - Phone:252-447-8907
Mailing Address - Fax:252-444-0923
Practice Address - Street 1:156 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-9506
Practice Address - Country:US
Practice Address - Phone:252-447-8907
Practice Address - Fax:252-444-0923
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107136Medicaid