Provider Demographics
NPI:1417313362
Name:SNYDER-SMITH, RAGAN L
Entity Type:Individual
Prefix:
First Name:RAGAN
Middle Name:L
Last Name:SNYDER-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAGAN
Other - Middle Name:
Other - Last Name:HACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:250 N ROCK RD STE 375
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2243
Mailing Address - Country:US
Mailing Address - Phone:316-202-8066
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD STE 375
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2243
Practice Address - Country:US
Practice Address - Phone:316-209-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS39621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical