Individual
BETHANY JEAN FANCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3408 30TH ST APT B45, LONG ISLAND CITY, NY 11106-3008
(718) 755-5361
Mailing address
3408 30TH ST APT B45, LONG ISLAND CITY, NY 11106-3008
(718) 755-5361
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009725
NY
225700000X
Massage Therapist
11756
TN
Other
Enumeration date
09/19/2019
Last updated
02/07/2021
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