| Doctor Name: | MR. ROBERT TRAVIS RAGON |
| NPI Number: | 1063496198 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S., M.DIV., L.P.C. |
| License Number: | 002031 |
| Business Practice Address: | 4031 Ne Lakewood Way Suite 100 Lees Summit, MO - 640642060 |
| Business Phone Number: | 8165259889 |
| Business Fax Number: | 8165540730 |
| Mailing Address: | 1044 Sw Zz Highway, GARDEN CITY |
| State: | MO |
| Postal Code: | 64747 |
| Phone Number: | 8165549330 |
| Fax Number: | 8165540730 |
| NPI Enumeration Date: | 12/01/2005 |
| NPI Last Update Date: | 02/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 002031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |