Provider Demographics
NPI:1457403388
Name:RAGSDALE, DAVID L
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:RAGSDALE
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 1:8000 E. PRENTICE AVE
Mailing Address - Street 2:B-5
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-324-6261
Mailing Address - Fax:303-694-1859
Practice Address - Street 1:8000 E. PRENTICE AVE
Practice Address - Street 2:B-5
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-324-6261
Practice Address - Fax:303-694-1859
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional