Provider Demographics
NPI:1700324498
Name:BUDHNA, MELISA SUBRINA
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:SUBRINA
Last Name:BUDHNA
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 1:7170 OKEECHOBEE BLVD APT 1412
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2488
Mailing Address - Country:US
Mailing Address - Phone:954-200-4722
Mailing Address - Fax:
Practice Address - Street 1:7170 OKEECHOBEE BLVD APT 1412
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2488
Practice Address - Country:US
Practice Address - Phone:954-200-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLSW240311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician