Provider Demographics
NPI:1821488016
Name:BADDELEY, JUDITH LYNN (MS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNN
Last Name:BADDELEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:LYNNE
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2293 WILLIAM COURT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598
Mailing Address - Country:US
Mailing Address - Phone:914-949-1719
Mailing Address - Fax:
Practice Address - Street 1:2293 WILLIAM COURT
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598
Practice Address - Country:US
Practice Address - Phone:914-949-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst