Individual
MR. MICHAEL B SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC, CART
Contact information
Practice address
625 CLAY ST, KERRVILLE, TX 78028-4586
(830) 377-3192
Mailing address
625 CLAY ST, KERRVILLE, TX 78028-4586
(830) 377-3192
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
8909
TX
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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