Individual
MR. BRYANT WAYNE RAGSDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA 1-16-22908
Contact information
Practice address
1609 COOPERS COVE RD, HARDY, VA 24101-2505
(505) 319-8123
Mailing address
1609 COOPERS COVE RD, HARDY, VA 24101-2505
(505) 319-8123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0133002576
VA
103K00000X
Behavior Analyst
Primary
1-16-22908
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88-3694357
—
VA
Enumeration date
06/29/2018
Last updated
03/03/2023
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