Severance, Melissa B
Severance, Melissa B is an sole proprietor health care provider with primary practice located at 11550 Stillwater Blvd N Ste 102 , Lake Elmo MN 55042-8613. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Severance, Melissa B can be contacted via phone (651) 777-3336.Contact Information
Primary practice address
11550 Stillwater Blvd N Ste 102
Lake Elmo MN 55042-8613
Phone: (651) 777-3336
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP3637 | Minnesota |
Profile Details
| NPI number | 1598821217 |
|---|---|
| LBN Legal business name | Severance, Melissa B |
| Credentials | MA LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598821217 | NPPES |
| Minnesota | Other | 41D05SE | BCBS INDIVIDUAL PROVIDER |
| Minnesota | Other | 41D04SE | BCBS INDIVIDUAL PROVIDER |
| Minnesota | Other | 6292882 | BCBS INDIVIDUAL PROVIDER |
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