Provider Demographics
NPI:1972898898
Name:BOTTONI BUDUR, ALLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALLA
Middle Name:
Last Name:BOTTONI BUDUR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1754 PICCADILLY CIR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6463
Mailing Address - Country:US
Mailing Address - Phone:610-248-9648
Mailing Address - Fax:
Practice Address - Street 1:1275 GLENLIVET DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-3107
Practice Address - Country:US
Practice Address - Phone:610-248-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016954103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical