Individual
SEVERIN G WELLINGHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4233 GATEWAY BLVD, NEWBURGH, IN 47630-8900
(812) 853-7391
(812) 858-6460
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 853-7391
(812) 858-6460
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040556A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247637
ANTHEM
IL
05
—
100102450
—
IN
Enumeration date
12/04/2006
Last updated
01/09/2013
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