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General NPI Number Information
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NPI Number | 1851865018
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Entity Type | Individual
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Provider Name | MISTY BUDZINSKI LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 582 FARGO TRL
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City | MIDDLETON
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State | WI
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Zip | 53562
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Country | US
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Telephone | 608-216-4374
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Fax | 608-716-3148
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Provider Business Mailing Address
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Address Line | 5310 MATHEWS RD APT 7
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City | MIDDLETON
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State | WI
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Zip | 53562-2448
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Country | US
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Telephone | 608-284-0844
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9086-123
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License Number State | WI
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