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Individual
MR. JACOB BANNON SPAVINS
Active
Individual
MR. JACOB BANNON SPAVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041S0200X
School Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/03/2012
Last updated
02/15/2018
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