Kiersten Severino
Occupational Therapy Assistant in Ellsworth Afb, SD. Individual provider (NPI-1).
NPI number1265316632
StatusActive
Last updated in NPPESJul 31, 2025
Details
- NPI
- 1265316632
- Entity type
- Individual (NPI-1)
- Name
- Kiersten Severino
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 31, 2025
- Certification date
- Jul 31, 2025
- Last updated
- Jul 31, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | – | – | Yes |
Practice location
987 Deadwood LoopEllsworth Afb, SD 57706-4204
Phone 712-331-1016
Mailing address
987 Deadwood LoopEllsworth Afb, SD 57706-4204
Phone 712-331-1016
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