Organization
GROVE AVENUE PROFESSIONAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE ELLIS MONTGOMERY PH.D. (PRESIDENT)
(804) 288-8823
Entity
Organization
Contact information
Practice address
505 LIBBIE AVE, RICHMOND, VA 23226-2617
(804) 288-8823
(804) 288-6423
Mailing address
505 LIBBIE AVE, RICHMOND, VA 23226-2617
(804) 288-8823
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000730
VA
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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