Provider Demographics
NPI:1144980178
Name:SOUCY, CELINE ALICE
Entity type:Individual
Prefix:
First Name:CELINE
Middle Name:ALICE
Last Name:SOUCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 SPIT BROOK RD STE 402
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5636
Mailing Address - Country:US
Mailing Address - Phone:978-764-5376
Mailing Address - Fax:
Practice Address - Street 1:71 SPIT BROOK RD STE 402
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5636
Practice Address - Country:US
Practice Address - Phone:978-764-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7896225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty