Provider Demographics
NPI:1730144973
Name:TOTH, JEAN L
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:L
Last Name:TOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1247
Mailing Address - Street 2:6B MARTIN ST
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2237
Mailing Address - Country:US
Mailing Address - Phone:207-764-8401
Mailing Address - Fax:207-768-5749
Practice Address - Street 1:6B MARTIN ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2237
Practice Address - Country:US
Practice Address - Phone:207-764-8401
Practice Address - Fax:207-768-5749
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP241237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME006669OtherANTHEM BC/BS OF ME
ME006669OtherANTHEM BC/BS OF ME