MEDICARE: CELENA HUGGINS LICENSED MASSOTHERAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	33024638

General Provider Information

NPI Number	:	1083494439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELENA HUGGINS LICENSED MASSOTHERAP

Provider Business Mailing Address
First Line	:	28895 LORAIN RD STE 200
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-4042
Country	:	US
Telephone Number	:	440-734-4084
Fax Number	:	440-734-4184

Provider Business Practice Location Address
First Line	:	3730 ROCKY RIVER DR STE 6
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-4044
Country	:	US
Telephone Number	:	216-671-7607
Fax Number	:	216-671-7608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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