Provider Demographics
NPI:1043968803
Name:BUDIRI, ZENA
Entity Type:Individual
Prefix:
First Name:ZENA
Middle Name:
Last Name:BUDIRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 N EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4570
Mailing Address - Country:US
Mailing Address - Phone:904-508-4599
Mailing Address - Fax:
Practice Address - Street 1:7829 E ROCKHILL ST STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3919
Practice Address - Country:US
Practice Address - Phone:316-686-5195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03981101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1568380OtherNATIONAL BOARD OF CERTIFIED COUNSELORS
KS03981OtherKANSAS BEHAVIORAL SCIENCES REGULATORY BOARD