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Individual

MRS. ZOEY C SEVERSON X

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
9800 SHELARD PKWY, MINNEAPOLIS, MN 55441-6411
(763) 522-0100
Mailing address
9800 SHELARD PKWY STE 325, MINNEAPOLIS, MN 55441-6453
(763) 522-0100

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
02355
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02355
BOARD OF BEHAVIORAL HEALTH AND THERAPY
MN
01
L055729-4
MINNESOTA BOARD OF NURSING
MN
Enumeration date
02/10/2020
Last updated
02/10/2020
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