Healthcare Provider Details

I. General information

NPI: 1346155025
Provider Name (Legal Business Name): CELENE KEALOHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 HWY 28
ALLENTON WI
53002-9735
US

IV. Provider business mailing address

6321 HWY 28
ALLENTON WI
53002-9735
US

V. Phone/Fax

Practice location:
  • Phone: 262-224-1203
  • Fax:
Mailing address:
  • Phone: 262-224-1203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: