Provider Demographics
NPI:1265869804
Name:BUDENZ, JUDEY M (PHD, HSPP)
Entity type:Individual
Prefix:DR
First Name:JUDEY
Middle Name:M
Last Name:BUDENZ
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:DR
Other - First Name:JUDEY
Other - Middle Name:M
Other - Last Name:BUDENZ-ANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, HSPP
Mailing Address - Street 1:417 ARNOLD CT
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3702
Mailing Address - Country:US
Mailing Address - Phone:765-450-4843
Mailing Address - Fax:765-450-4895
Practice Address - Street 1:417 ARNOLD CT
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3702
Practice Address - Country:US
Practice Address - Phone:765-450-4843
Practice Address - Fax:745-048-9565
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042944A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN20042944AOtherLICENSE
IN201368320Medicaid
IN1007340OtherLICENSE