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Individual
DON LYLE SEVERN
Active
Individual
DON LYLE SEVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CI21700218 (CADC 1 )
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CI21700218
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265560130
—
CA
Enumeration date
12/05/2018
Last updated
12/05/2018
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