Provider Information for 1609901008
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CHARLES MICHEL LCSW
Sex: Male
NPI: 1609901008
Last Updated: 2013-04-17
Certification Date:
Certification Date:
Details
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NPI | 1609901008 | ||||||||
Enumeration Date | 2007-02-23 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | PO BOX 6459 KOKOMO, IN 46904-6459 United States Phone: 765-453-7422 | Fax:765-453-3773 | ||||||||
Primary Practice Address | 702 W ALTO RD KOKOMO, IN 46902-4907 United States Phone: 765-453-7422 | Fax:765-453-3773 | ||||||||
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