Individual
MITCHELL JOHN CHMELIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Mailing address
120 QUINCY AVE, ROSEBURG, OR 97471-4995
(630) 335-2060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6881
OR
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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