Provider Demographics
NPI:1396556791
Name:SALE, RAFAELLA (PHD)
Entity type:Individual
Prefix:
First Name:RAFAELLA
Middle Name:
Last Name:SALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 E MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7432
Mailing Address - Country:US
Mailing Address - Phone:512-202-2688
Mailing Address - Fax:
Practice Address - Street 1:2924 EMERYWOOD PKWY STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-3746
Practice Address - Country:US
Practice Address - Phone:804-396-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008733103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical