Individual
CHARLES J CHMIELEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., L.P.
Contact information
Practice address
1526 30TH ST NW, BEMIDJI, MN 56601-4133
(218) 751-0887
Mailing address
1526 30TH ST NW, BEMIDJI, MN 56601-4133
(218) 751-0887
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1921
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373748900
—
MN
Enumeration date
06/28/2005
Last updated
09/13/2010
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