Healthcare Provider Details

I. General information

NPI: 1538090162
Provider Name (Legal Business Name): ANGELINA ROSE CILELLA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3456 TEJON ST
DENVER CO
80211-3435
US

IV. Provider business mailing address

360 W 13TH AVE UNIT 1102
DENVER CO
80204-2741
US

V. Phone/Fax

Practice location:
  • Phone: 720-484-6386
  • Fax:
Mailing address:
  • Phone: 720-484-6386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0027045
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: