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General NPI Number Information
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NPI Number | 1588574388
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Entity Type | Individual
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Provider Name | CELESTE ARIANNA CLARKE LMT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 5000 AUSTELL POWDER SPRINGS RD STE 113
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City | AUSTELL
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State | GA
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Zip | 30106-2428
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Country | US
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Telephone | 678-453-2647
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Fax |
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Provider Business Mailing Address
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Address Line | 612 PRESTON LANDING CIR # 612
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-6856
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Country | US
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Telephone | 678-453-2647
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT015650
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License Number State | GA
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