Individual
KATHERINE SUSSKIND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, ATC
Contact information
Practice address
641 CAMPUS DR, STANFORD, CA 94305-6201
(650) 497-3953
Mailing address
641 CAMPUS DR, STANFORD, CA 94305-6201
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000010658
CA
Other
Enumeration date
05/27/2014
Last updated
01/25/2020
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