Provider Demographics
NPI:1891932059
Name:DAMAN, JAMES C
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:DAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 E. 141ST PL.
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033
Mailing Address - Country:US
Mailing Address - Phone:918-289-1434
Mailing Address - Fax:
Practice Address - Street 1:650 E 141ST PL
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-3624
Practice Address - Country:US
Practice Address - Phone:918-289-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)