MEDICARE: SARAH RAMBY PHILLIPS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0810004732	VA

General Provider Information

NPI Number	:	1457029555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RAMBY PHILLIPS PHD

Provider Business Mailing Address
First Line	:	3812 CONCORD PL STE 3
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-3654
Country	:	US
Telephone Number	:	540-200-7135
Fax Number	:

Provider Business Practice Location Address
First Line	:	3812 CONCORD PL STE 3
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-3654
Country	:	US
Telephone Number	:	540-200-7135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	02/17/2022

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