Provider Demographics
NPI:1588044119
Name:GROSS, BARBARA (BCBA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 IMPERIAL PT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-6952
Mailing Address - Country:US
Mailing Address - Phone:314-649-0222
Mailing Address - Fax:
Practice Address - Street 1:48 CLARKSON WILSON CTR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7276
Practice Address - Country:US
Practice Address - Phone:314-649-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015011548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst