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General NPI Number Information
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NPI Number | 1063616522
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Entity Type | Individual
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Provider Name | NINA B DAMERON MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 232 N EDGEWORTH ST ROOM 224
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City | GREENSBORO
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State | NC
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Zip | 27401-2218
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Country | US
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Telephone | 336-641-6437
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Fax | 336-641-6436
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Provider Business Mailing Address
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Address Line | 4806 COUNTRY WOODS LN
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City | GREENSBORO
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State | NC
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Zip | 27410-1814
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Country | US
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Telephone | 336-294-0400
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Fax | 336-641-6436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2864
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License Number State | NC
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