Healthcare Provider Details

I. General information

NPI: 1316833924
Provider Name (Legal Business Name): ALYSSA NICOLE RAPOLE MS-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WILKES RIDGE DR
RICHMOND VA
23233-7632
US

IV. Provider business mailing address

17901 MAGNOLIA FIELDS LOOP APT 301
MOSELEY VA
23120-1878
US

V. Phone/Fax

Practice location:
  • Phone: 804-877-4000
  • Fax:
Mailing address:
  • Phone: 434-547-9442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2204001543
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: