Provider Demographics
NPI:1407076284
Name:MONTGOMERY PROFESSIONAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MONTGOMERY PROFESSIONAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:R.
Authorized Official - Middle Name:MARA
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-984-2800
Mailing Address - Street 1:4422 CARVER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5536
Mailing Address - Country:US
Mailing Address - Phone:513-984-2800
Mailing Address - Fax:513-984-2844
Practice Address - Street 1:4422 CARVER WOODS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5536
Practice Address - Country:US
Practice Address - Phone:513-984-2800
Practice Address - Fax:513-984-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty