Provider Demographics
NPI:1255203568
Name:GASPER, JAUCELYN MARIE
Entity type:Individual
Prefix:
First Name:JAUCELYN
Middle Name:MARIE
Last Name:GASPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32665
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2665
Mailing Address - Country:US
Mailing Address - Phone:865-312-8220
Mailing Address - Fax:833-550-1727
Practice Address - Street 1:1009 COMMERCE PARK DR STE 350
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-8075
Practice Address - Country:US
Practice Address - Phone:865-312-8220
Practice Address - Fax:833-550-1727
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-22-235705106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician