Provider Demographics
NPI:1306862362
Name:MARINO, CATHERINE M (AUD,CCC/A)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:MARINO
Suffix:
Gender:F
Credentials:AUD,CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-9411
Mailing Address - Country:US
Mailing Address - Phone:610-742-2038
Mailing Address - Fax:
Practice Address - Street 1:80 W WELSH POOL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1233
Practice Address - Country:US
Practice Address - Phone:610-363-2532
Practice Address - Fax:610-363-0210
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000461L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01650378-01OtherAMERICHOICE
PA294019OtherINDEPENDENCE BLUE CROSS
PA0461605000OtherKEYSTONE HEALTH PLAN EAST
PA1154155OtherKEYSTONE MERCY HEALTH PLA
PA0461605000OtherKEYSTONE HEALTH PLAN EAST