Provider Demographics
NPI:1326144742
Name:BADUNA, DANA TAMARA (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:DANA
Middle Name:TAMARA
Last Name:BADUNA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTRAL AVE
Mailing Address - Street 2:#605
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3845
Mailing Address - Country:US
Mailing Address - Phone:813-787-3883
Mailing Address - Fax:
Practice Address - Street 1:1135 PASADENA AVE S
Practice Address - Street 2:SUITE 309
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-2887
Practice Address - Country:US
Practice Address - Phone:727-674-5053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1677106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist