Healthcare Provider Details

I. General information

NPI: 1952228306
Provider Name (Legal Business Name): ELENA GRACE CELLITTI OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TABERNACLE RD
BLACK MOUNTAIN NC
28711-2592
US

IV. Provider business mailing address

58 E GLENVIEW ST
MARION NC
28752-4725
US

V. Phone/Fax

Practice location:
  • Phone: 828-357-3611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18583
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: