Individual
MS. DEBRA JILL SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
23758 STATE ROAD 35, SIREN, WI 54872-0356
(715) 349-8913
(715) 349-8981
Mailing address
1821 1 1/2 ST, PO BOX 27, COMSTOCK, WI 54826-0027
(715) 822-2075
(714) 822-2205
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1116 125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1116 125
PROFESSIONAL COUNSELOR
WI
05
—
39772500
—
WI
Enumeration date
09/21/2007
Last updated
09/21/2007
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