Individual
MRS. KAYLA FRANCES SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, SAC
Contact information
Practice address
840 STATE ROAD 136 STE 1, BARABOO, WI 53913-9252
(608) 477-9858
(877) 560-0578
Mailing address
840 STATE ROAD 136 STE 1, BARABOO, WI 53913-9252
(084) 779-8586
(877) 560-0578
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16324-131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100079039
—
WI
Enumeration date
03/23/2016
Last updated
03/23/2021
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