Provider Demographics
NPI:1275911786
Name:SESOCK, KAITLIN (MGC, CGC)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:SESOCK
Suffix:
Gender:F
Credentials:MGC, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:NE50
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-636-5535
Mailing Address - Fax:216-636-0009
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:NE50
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-636-5535
Practice Address - Fax:216-636-0009
Is Sole Proprietor?:No
Enumeration Date:2015-05-16
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000122170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS