MEDICARE: KATHI KEIR-COLLI LMFT

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
1	106H00000X	Marriage & Family Therapist	MFC40610	CA

General Provider Information

NPI Number	:	1053524926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHI KEIR-COLLI LMFT

Provider Business Mailing Address
First Line	:	1611 S PACIFIC COAST HWY STE 204
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5611
Country	:	US
Telephone Number	:	310-204-9750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 S PACIFIC COAST HWY STE 204
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5611
Country	:	US
Telephone Number	:	310-204-9750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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Directions to “ KATHI KEIR-COLLI LMFT” Practice Location

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