Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 0654 | ND |
NPI | 1003496589 |
---|---|
Provider Name | Meggan Michelle Severson |
First Address | Bismarck, ND 58504-6644 |
Second Address | Bismarck, ND 58504-6644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2021 |
Last Update Date | 09/04/2021 |