Provider Demographics
NPI:1467649186
Name:KEENE, MARGARET VALIANT (MA, MFC 46842)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:VALIANT
Last Name:KEENE
Suffix:
Gender:F
Credentials:MA, MFC 46842
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-0113
Mailing Address - Country:US
Mailing Address - Phone:310-775-7039
Mailing Address - Fax:
Practice Address - Street 1:1949 1/2 WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8414
Practice Address - Country:US
Practice Address - Phone:310-775-7039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46842106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist