Etete L. Agbabune, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

1745 Issued in AL

Practice address

3303 Westmill Dr SW Ste 8
Huntsville, AL 35805-6133

Phone

(256) 326-0890

Fax

(256) 326-0890

NPI assigned

Dec 3, 2008

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Etete L. Agbabune-Torres Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1518102722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11551",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358141551",
            "telephone_number": "256-326-0890",
            "fax_number": "256-289-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 WESTMILL DR SW STE 8",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358056133",
            "telephone_number": "256-326-0890",
            "fax_number": "256-326-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBABUNE",
        "first_name": "ETETE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": "1745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-46177",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ETETE",
            "last_name": "AGBABUNE-TORRES",
            "middle_name": "L.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Massage Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.