MEDICARE: MARY F. KEMP 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

General Provider Information

NPI Number	:	1912027939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY F. KEMP LMFT

Provider Business Mailing Address
First Line	:	1304 E MAIN ST
Second Line	:	SUITE D
City	:	VENTURA
State	:	CA
Zip	:	93001-3202
Country	:	US
Telephone Number	:	805-643-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 E MAIN ST
Second Line	:	SUITE D
City	:	VENTURA
State	:	CA
Zip	:	93001-3202
Country	:	US
Telephone Number	:	805-643-0300
Fax Number	:

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

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	07/08/2007

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