Individual
MS. JENNIFER MICHELLE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA, LBA
Contact information
Practice address
4900 MERCURY DR STE D, DEARBORN, MI 48126-2947
(313) 612-5571
Mailing address
100 N PACIFIC COAST HWY STE 1400, EL SEGUNDO, CA 90245-5602
(310) 856-0800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-19-36269
MI
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
02/10/2014
Last updated
05/19/2025
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