Healthcare Provider Details

I. General information

NPI: 1326614702
Provider Name (Legal Business Name): ANGELA D RUGGLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA D RUGGLES

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 S 3RD ST
IRONTON OH
45638-1853
US

IV. Provider business mailing address

4300 OLD SCIOTO TRL
PORTSMOUTH OH
45662-6642
US

V. Phone/Fax

Practice location:
  • Phone: 740-302-3500
  • Fax: 740-529-0553
Mailing address:
  • Phone: 740-302-3500
  • Fax: 740-529-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.183973
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberQMHS.HSGED
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: