Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | A-046-196 | KS |
NPI | 1104172337 |
---|---|
Provider Name | Ms. Julie Anne Budke |
First Address | Prairie Village, KS 66208 |
Second Address | Prairie Village, KS 66208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2012 |
Last Update Date | 25/07/2012 |