Healthcare Provider Details

I. General information

NPI: 1851565410
Provider Name (Legal Business Name): CHARLENE A. BUDRIUS I CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ELM ST
WALTHAM MA
02453-5356
US

IV. Provider business mailing address

9 ADDISON ST
ARLINGTON MA
02476-8107
US

V. Phone/Fax

Practice location:
  • Phone: 781-894-8440
  • Fax: 781-894-1202
Mailing address:
  • Phone: 781-643-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number115701
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: