Individual
JOSEPH C THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNM
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-8541
(419) 480-1340
Mailing address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-8541
(419) 480-1340
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
04290
OH
367A00000X
Advanced Practice Midwife
Primary
NM-04290
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000031422
ANTHEM
OH
01
—
05225
PARAMOUNT
OH
05
—
2065045
—
OH
01
—
344428256
BEECHSTREET
OH
01
—
344428256090
CARESOURCE
OH
05
—
3471545
—
MI
Enumeration date
07/14/2005
Last updated
02/19/2014
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