Provider Demographics
NPI:1699558882
Name:THALER, ABBIGAIL (CBD)
Entity type:Individual
Prefix:
First Name:ABBIGAIL
Middle Name:
Last Name:THALER
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:08048 M 40
Mailing Address - Street 2:
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-9080
Mailing Address - Country:US
Mailing Address - Phone:269-767-6659
Mailing Address - Fax:
Practice Address - Street 1:08048 M 40
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-9080
Practice Address - Country:US
Practice Address - Phone:269-767-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIATH-108708374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula