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General NPI Number Information
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NPI Number | 1447924139
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Entity Type | Individual
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Provider Name | CELENA HENRIQUEZ PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 09/10/2023
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Provider Practice Location Address
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Address Line | 568 SANDHURST DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4426
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Country | US
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Telephone | 910-484-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1427 JANIKE LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6558
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Country | US
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Telephone | 717-269-6832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT37473
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License Number State | FL
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