Severino-Clemente, Mary Agnes
Severino-Clemente, Mary Agnes is an sole proprietor health care provider with primary practice located at 11442 White Oak Ave , Granada Hills CA 91344-3334. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Severino-Clemente, Mary Agnes can be contacted via phone (818) 687-8981.Contact Information
Primary practice address
11442 White Oak Ave
Granada Hills CA 91344-3334
Phone: (818) 687-8981
Fax: (818) 435-2081
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT21507 | California |
Profile Details
| NPI number | 1235278334 |
|---|---|
| LBN Legal business name | Severino-Clemente, Mary Agnes |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2007 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235278334 | NPPES |
| California | Other | PT21507 | PROVIDER NUMBER |
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