Individual
JENNIFER LEIGH GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4959 UTICA RIDGE RD, DAVENPORT, IA 52807-3063
(888) 228-8476
Mailing address
4959 UTICA RIDGE RD, DAVENPORT, IA 52807-3063
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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