Healthcare Provider Details

I. General information

NPI: 1356302244
Provider Name (Legal Business Name): PATRICIA JEAN BUDD PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 BRODHEAD RD SUITE 130
BETHLEHEM PA
18020-9201
US

IV. Provider business mailing address

2940 WASHINGTON ST
EASTON PA
18045-2562
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-7727
  • Fax: 610-868-7727
Mailing address:
  • Phone: 610-252-8859
  • Fax: 610-868-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS007507-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: