Individual
SHANTEL SUSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3306 E MAIN ST, ENDWELL, NY 13760-5955
(607) 296-0572
Mailing address
3306 E MAIN ST, ENDWELL, NY 13760-5955
(607) 296-0572
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
02/09/2021
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