Provider Demographics
NPI:1710585088
Name:VICKI S RAGSDELL, PHD PLLC
Entity Type:Organization
Organization Name:VICKI S RAGSDELL, PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGSDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-314-8835
Mailing Address - Street 1:12004 LOG CABIN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2218
Mailing Address - Country:US
Mailing Address - Phone:502-314-8835
Mailing Address - Fax:
Practice Address - Street 1:12004 LOG CABIN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2218
Practice Address - Country:US
Practice Address - Phone:502-314-8835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health