Provider Demographics
NPI:1316235567
Name:BABUSKA, KATHLEEN BRUDER (MSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BRUDER
Last Name:BABUSKA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 N HURON ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2607
Mailing Address - Country:US
Mailing Address - Phone:734-714-2258
Mailing Address - Fax:734-484-3100
Practice Address - Street 1:206 MILFORD ST
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1309
Practice Address - Country:US
Practice Address - Phone:508-729-7000
Practice Address - Fax:508-529-7024
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical