Individual
DR. JONATHAN DREW GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
9310 OLD KINGS RD S, SUITE 102, JACKSONVILLE, FL 32257-6152
(904) 437-5176
(904) 438-3175
Mailing address
9310 OLD KINGS RD S, SUITE 102, JACKSONVILLE, FL 32257-6152
(904) 437-5176
(904) 438-3175
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY003602
GA
103G00000X
Clinical Neuropsychologist
Primary
PY 8505
FL
103TC0700X
Clinical Psychologist
PY 8505
FL
Other
Enumeration date
04/18/2012
Last updated
09/11/2013
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