Provider Demographics
NPI:1366333676
Name:MARVIN, KATELYN DIANE (LGC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:DIANE
Last Name:MARVIN
Suffix:
Gender:F
Credentials:LGC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:DIANE
Other - Last Name:FINNEGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF MEDICAL GENETICS AND GENOMICS
Mailing Address - Street 2:9500 EUCLID AVENUE, C15
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195
Mailing Address - Country:US
Mailing Address - Phone:216-636-1768
Mailing Address - Fax:216-445-6935
Practice Address - Street 1:DEPARTMENT OF MEDICAL GENETICS AND GENOMICS
Practice Address - Street 2:9500 EUCLID AVENUE, C15
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-636-1768
Practice Address - Fax:216-445-6935
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000951TEMP170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS