Individual
JACOB MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5722 CABIN CREEK RD, DAWES, WV 25054-7700
(304) 595-5006
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
08/05/2020
Last updated
10/08/2021
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