Individual
MRS. KELLY ANNE BURKE SUSTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5044 MAYFIELD RD, LYNDHURST, OH 44124-2605
(216) 691-2000
Mailing address
2672 BELVOIR BLVD, SHAKER HEIGHTS, OH 44122-1924
(216) 650-0420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP10182
OH
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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