Individual
KARLA JAYNE RAGSDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1161 FORTUNE BLVD STE 200, SHILOH, IL 62269-7385
(618) 314-0547
Mailing address
1161 FORTUNE BLVD STE 200, SHILOH, IL 62269-7385
(618) 314-0547
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
180012510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558849323
NPI
IL
Enumeration date
08/02/2018
Last updated
10/22/2020
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