MEDICARE: KATHLEEN MARIE MCINTOSH

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

General Provider Information

NPI Number	:	1861831000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MARIE MCINTOSH

Provider Business Mailing Address
First Line	:	9 CAMINO ARROYO PL
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-0326
Country	:	US
Telephone Number	:	760-568-0822
Fax Number	:	760-568-0822

Provider Business Practice Location Address
First Line	:	44199 MONROE ST STE B
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-3094
Country	:	US
Telephone Number	:	760-863-8327
Fax Number	:

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

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	06/20/2013

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Directions to “ KATHLEEN MARIE MCINTOSH ” Practice Location

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