National Provider Identifier

Molly Michele Champagne-Forte, LMT

Molly Michele Champagne-Forte, LMT is listed in the NPPES registry with a primary specialty of Occupational Therapist in Clarence, NY and a listed phone number of (315) 813-2313.

NPI 1023759545Clarence, NYOccupational Therapist

Profile Overview

NPI
1023759545
Provider Type
Individual
Primary Specialty
Occupational Therapist
Enumeration Date
April 06, 2022
Last Updated
September 15, 2025

Practice Location

  • 10225 Main St
  • Clarence, NY 14031-2053

Phone: (315) 813-2313

Mailing Address

  • 8588 Hunt Ave
  • Eden, NY 14057-1314

Specialties

  • Occupational Therapist (225X00000X)
  • Massage Therapist (225700000X)
Full Record
NPI
1023759545
Entity Type
Individual
Last Name
Champagne-Forte
First Name
Molly
Middle Name
Michele
Credential
LMT
Provider Other Last Name
Wagner
Provider Other First Name
Molly
Provider Other Middle Name
Michele
Provider Other Last Name Type Code
1
Mailing Street Address
8588 Hunt Ave
Mailing City
Eden
Mailing State
NY
Mailing ZIP Code
14057-1314
Mailing Country
US
Mailing Phone
(315) 813-2313
Practice Street Address
10225 Main St
Practice City
Clarence
Practice State
NY
Practice ZIP Code
14031-2053
Practice Country
US
Practice Phone
(315) 813-2313
Enumeration Date
April 06, 2022
Last Updated
September 15, 2025
Sex
Female
Sole Proprietor
Yes
Certification Date
September 15, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapist (225X00000X), Massage Therapist (225700000X)