Provider Demographics
NPI:1629506944
Name:BUDORA, SHAYLEE NICOLE (CMHC)
Entity type:Individual
Prefix:
First Name:SHAYLEE
Middle Name:NICOLE
Last Name:BUDORA
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 S MAIN ST STE B2
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4335
Mailing Address - Country:US
Mailing Address - Phone:385-238-5701
Mailing Address - Fax:
Practice Address - Street 1:952 S MAIN ST STE B2
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4335
Practice Address - Country:US
Practice Address - Phone:385-238-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10228629-6004101YM0800X
UT10228629-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health