Healthcare Provider Details

I. General information

NPI: 1467381194
Provider Name (Legal Business Name): KRISTIN IRENE SUTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 DELAWARE AVE UNIT B
LAUREL DE
19956-1181
US

IV. Provider business mailing address

1034 W STEIN HWY
SEAFORD DE
19973-1145
US

V. Phone/Fax

Practice location:
  • Phone: 443-262-2484
  • Fax:
Mailing address:
  • Phone: 302-327-9259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-494944
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: