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NPI Code Detail

MEDICARE: MRS. JENNY MARIE MORK MA

MEDICARE:  MRS. JENNY MARIE MORK  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist68706CA

General Provider Information

NPI Number : 1326175407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNY MARIE MORK MA
Provider Business Mailing Address
First Line : 9412 BIG HORN BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-1101
Country : US
Telephone Number : 916-226-2800
Fax Number : 916-226-2804
Provider Business Practice Location Address
First Line : 9412 BIG HORN BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-1101
Country : US
Telephone Number : 916-226-2800
Fax Number : 916-226-2804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/20/2012

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Directions to “ MRS. JENNY MARIE MORK MA” Practice Location

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