Individual
KATHERINE MARIE SUSTACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1515 SAINT FRANCIS AVE, SHAKOPEE, MN 55379-3387
(952) 403-2001
Mailing address
740 DEBBIE LN, CARVER, MN 55315-9306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101821
MN
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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