Healthcare Provider Details

I. General information

NPI: 1184532715
Provider Name (Legal Business Name): LINDSAY MARIE MAHAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23150 S 224TH PL
QUEEN CREEK AZ
85142-9680
US

IV. Provider business mailing address

1101 RED VENTURES DR
FORT MILL SC
29707-5005
US

V. Phone/Fax

Practice location:
  • Phone: 612-275-0531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3921065
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: