Individual
GEORGE MICHAEL DAMOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., ED.S.
Contact information
Practice address
218 D ST, SOUTH CHARLESTON, WV 25303-3104
(304) 720-3835
(304) 720-3836
Mailing address
218 D ST, SOUTH CHARLESTON, WV 25303-3104
(304) 720-3835
(304) 720-3836
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
748
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165187000
—
WV
Enumeration date
03/12/2007
Last updated
07/08/2007
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