Individual
LORETTA LEE SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
51 MAIN ST, LINCOLN, ME 04457-1439
(207) 290-1924
Mailing address
PO BOX 92, MEDWAY, ME 04460-0092
(207) 290-1924
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1263
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433573599
—
ME
Enumeration date
02/23/2009
Last updated
08/05/2010
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