Healthcare Provider Details

I. General information

NPI: 1124933692
Provider Name (Legal Business Name): LINDSEY MAHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WESTERN AVE
MANITOWOC WI
54220-3712
US

IV. Provider business mailing address

4510 MENASHA AVE
MANITOWOC WI
54220-1154
US

V. Phone/Fax

Practice location:
  • Phone: 920-320-3100
  • Fax: 920-320-5114
Mailing address:
  • Phone: 920-320-3100
  • Fax: 920-320-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14538621
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: