Individual
MR. JACOB GERARD BAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, MED
Contact information
Practice address
13303 TESSON FERRY RD STE 50, SAINT LOUIS, MO 63128-4062
(636) 379-1779
(636) 634-3496
Mailing address
13303 TESSON FERRY RD STE 50, SAINT LOUIS, MO 63128-4062
(636) 379-1779
(636) 634-3496
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2022049314
MO
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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