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Mr. Gary Lee Mcderment JR., PRSS
Peer Specialist in Kenova, West Virginia
NPI 1477331163

Gary Lee Mcderment JR. is a Peer Specialist based in Kenova, WV. Gary Lee Mcderment JR. practices in Kenova, WV and has the professional credentials of PRSS. The NPI Number for Gary Lee Mcderment JR. is 1477331163 and holds a License No. 23-9188 (West Virginia).

The current practice location address for Gary Lee Mcderment JR. is 802 Oak St, Kenova, WV and can be reached out via phone at 304-908-1056.

Location: 802 Oak St, Kenova, WV, 25530-1519
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477331163
Provider Name
Gary Lee Mcderment JR.
Credential
PRSS
Provider Entity Type
Individual
Gender
Male
Address
802 Oak St, Kenova, WV, 25530-1519
Phone Number
304-908-1056
Fax Number
Provider Enumeration Date
09/15/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
802 Oak St
City
Kenova
State
West Virginia
Zip
25530-1519
Phone Number
304-908-1056
Fax Number
person
Provider Business Mailing Address Details
Address
802 Oak St
City
Kenova
State
West Virginia
Zip
25530-1519
Phone Number
304-908-1056
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
23-9188 (West Virginia)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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