Provider Demographics
NPI:1093686495
Name:SUTHAN, ABIRAMI
Entity type:Individual
Prefix:
First Name:ABIRAMI
Middle Name:
Last Name:SUTHAN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2996
Mailing Address - Country:US
Mailing Address - Phone:972-533-9391
Mailing Address - Fax:
Practice Address - Street 1:43155 MAIN ST STE 2300G
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1889
Practice Address - Country:US
Practice Address - Phone:734-323-4897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362010263103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist