MEDICARE: MOLLY MYRIAH NELSON

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	9053	MA

General Provider Information

NPI Number	:	1881546117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY MYRIAH NELSON

Provider Business Mailing Address
First Line	:	1550 FALMOUTH RD STE 4C
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 FALMOUTH RD STE 4C
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2938
Country	:	US
Telephone Number	:	508-776-1305
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ MOLLY MYRIAH NELSON ” Practice Location

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