Individual
CAROL THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
150 S MOUNT AUBURN RD STE 420, CAPE GIRARDEAU, MO 63703-4911
(573) 335-7708
(573) 334-9631
Mailing address
PO BOX 843225, KANSAS CITY, MO 64184-3225
(708) 633-1234
(708) 342-7100
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2000148105
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710129200
TRIWEST
MO
01
—
A67294
HEALTHLINK
MO
Enumeration date
03/30/2009
Last updated
03/18/2012
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