Provider Demographics
NPI:1720578974
Name:RICHMOND GEROPSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:RICHMOND GEROPSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FROMME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-467-2022
Mailing Address - Street 1:1210 SANTA ROSA RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5842
Mailing Address - Country:US
Mailing Address - Phone:804-467-2022
Mailing Address - Fax:
Practice Address - Street 1:2800 N PARHAM RD STE 107
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4409
Practice Address - Country:US
Practice Address - Phone:804-467-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004125103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty