Provider Demographics
NPI:1427287770
Name:MAHER, LINDA LEE (CMT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEE
Last Name:MAHER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 STATE ST. N
Mailing Address - Street 2:
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093-2928
Mailing Address - Country:US
Mailing Address - Phone:507-835-7660
Mailing Address - Fax:
Practice Address - Street 1:117 STATE ST. N.
Practice Address - Street 2:
Practice Address - City:WASECA
Practice Address - State:MN
Practice Address - Zip Code:56093-2928
Practice Address - Country:US
Practice Address - Phone:507-835-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN555697250202396225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist