Provider Demographics
NPI:1366032138
Name:BUDELMANN, KATIE VICTORIA
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:VICTORIA
Last Name:BUDELMANN
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 1:540 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2405
Mailing Address - Country:US
Mailing Address - Phone:908-722-1881
Mailing Address - Fax:
Practice Address - Street 1:540 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2405
Practice Address - Country:US
Practice Address - Phone:908-722-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL054888001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical