Individual
CHARLES R MICHELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
9792 HWY 70 W, MINOCQUA, WI 54548
(715) 356-1793
Mailing address
9612 MANITOU PARK DR, MINOCQUA, WI 54548-9302
(715) 356-2186
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
666
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39504900
—
WI
Enumeration date
08/31/2006
Last updated
12/11/2007
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