Provider Demographics
NPI:1326775735
Name:MOCHA MOMMA LLC
Entity Type:Organization
Organization Name:MOCHA MOMMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERINATAL DOULA
Authorized Official - Prefix:
Authorized Official - First Name:SHARNESE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-435-4700
Mailing Address - Street 1:8 STATE ST APT L
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-2841
Mailing Address - Country:US
Mailing Address - Phone:401-263-8785
Mailing Address - Fax:
Practice Address - Street 1:8 STATE ST APT L
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-2841
Practice Address - Country:US
Practice Address - Phone:401-263-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty