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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
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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