Individual
CARLY BLEMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSHR. LPC
Contact information
Practice address
2589 NW EDENBOWER BLVD, ROSEBURG, OR 97471-6224
(541) 839-1345
Mailing address
PO BOX 740, TALIHINA, OK 74571-0740
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7774
OK
101YP2500X
Professional Counselor
Primary
C6861
OR
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/18/2015
Last updated
08/14/2023
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