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Individual

MRS. JENNIFER LEIGH GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A. CCC-SLP

Contact information

Practice address
543 GENERAL CRUFT DR, RICHMOND, KY 40475-7520
(859) 582-3659
Mailing address
543 GENERAL CRUFT DR, RICHMOND, KY 40475-7520
(859) 582-3659

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2151
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235Z00000X
KY
Enumeration date
03/04/2016
Last updated
03/04/2016
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