Individual
MR. JACOB M BOUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LGSW
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
BP00945821
WV
1041C0700X
Clinical Social Worker
SW062015550
WV
Other
Enumeration date
10/30/2020
Last updated
02/01/2021
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