MEDICARE: MS. KATHERINE PHILO

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1912568973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE PHILO

Provider Business Mailing Address
First Line	:	2010 E 90TH ST # R4-020
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2971
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 E 90TH ST # R4020
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2971
Country	:	US
Telephone Number	:	216-445-7862
Fax Number	:

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

Provider Enumeration Date	:	06/21/2019
Last Update Date	:	06/21/2019

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Directions to “ MS. KATHERINE PHILO ” Practice Location

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