Provider Demographics
NPI:1255971487
Name:SEVIG, EMILY (OT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SEVIG
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 UNIVERSITY AVE W STE 140
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1844
Mailing Address - Country:US
Mailing Address - Phone:612-523-2397
Mailing Address - Fax:
Practice Address - Street 1:2200 UNIVERSITY AVE W STE 140
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1844
Practice Address - Country:US
Practice Address - Phone:612-532-2397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist