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Individual
SUE LAURA SEVERANCE
Active
Individual
SUE LAURA SEVERANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004593
MO
1041C0700X
Clinical Social Worker
2420
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
Enumeration date
01/16/2007
Last updated
10/01/2021
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