Provider Demographics
NPI:1821057274
Name:THIBERT, JANET M (AUD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:THIBERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 VELP AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-6592
Mailing Address - Country:US
Mailing Address - Phone:920-434-6777
Mailing Address - Fax:920-434-6988
Practice Address - Street 1:2331 VELP AVE
Practice Address - Street 2:SUITE G
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-6592
Practice Address - Country:US
Practice Address - Phone:920-434-6777
Practice Address - Fax:920-434-6988
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI464-156237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter