Individual
KIERSTEN SEVERINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
987 DEADWOOD LOOP, ELLSWORTH AFB, SD 57706-4204
(712) 331-1016
Mailing address
987 DEADWOOD LOOP, ELLSWORTH AFB, SD 57706-4204
(712) 331-1016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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