Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marie Fanham, LMT

Individual provider Massage Therapist · NPI 1295189017

Marie Fanham, LMT is a Massage Therapist in Brockport, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2016
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

29 Clinton St
Brockport, NY 14420-1803
Phone: (585) 637-3126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 029413-1 (NY)

Record details

NPI number1295189017
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMT
Sole proprietorYes
NPI enumeratedApril 18, 2016
Last updated in NPPESApril 18, 2016
Mailing address29 Clinton St, Brockport, NY 14420-1803

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