Provider Information for 1790102978
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Mrs. MARI MOONCOOK M.A.
Other Names:Professional Name:Mrs. JESSE MARI MOONCOOK M.A,Sex: Female
NPI: 1790102978
Last Updated: 2014-03-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1790102978 | ||||||||
| Enumeration Date | 2014-03-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1301 BROOK PL MOUNTAIN VIEW, CA 94040-3908 United States Phone: 650-465-9331 | Fax:650-864-9006 | ||||||||
| Primary Practice Address | 1301 BROOK PL MOUNTAIN VIEW, CA 94040-3908 United States Phone: 650-465-9331 | Fax:650-864-9006 | ||||||||
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