Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 06-04P | AR |
N | 103T00000X | Psychologist | 06-04P | AR |
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1269 | NH |
NPI | 1376633941 |
---|---|
Provider Name | Alan Budney |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 29/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160337719 | (05) | AR |