Healthcare Provider Details

I. General information

NPI: 1730858317
Provider Name (Legal Business Name): KATRINA SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9237 ARLINGTON DR
YPSILANTI MI
48198-9470
US

IV. Provider business mailing address

120 S MAIN ST STE C
MILFORD MI
48381-1975
US

V. Phone/Fax

Practice location:
  • Phone: 734-406-4572
  • Fax:
Mailing address:
  • Phone: 248-529-6383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: