Provider Demographics
NPI:1467681676
Name:GROSSER, JASON WILLIAM (MA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:WILLIAM
Last Name:GROSSER
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 MORNING GARDEN CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-3200
Mailing Address - Country:US
Mailing Address - Phone:901-229-3513
Mailing Address - Fax:
Practice Address - Street 1:9300 MORNING GARDEN CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-3200
Practice Address - Country:US
Practice Address - Phone:901-229-3513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst