Provider Demographics
NPI:1508096199
Name:WEBSTER, EMILY RUTH (BCBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RUTH
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RUTH
Other - Last Name:WESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:140 JOE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AL
Mailing Address - Zip Code:35096-6157
Mailing Address - Country:US
Mailing Address - Phone:256-473-1080
Mailing Address - Fax:
Practice Address - Street 1:140 JOE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AL
Practice Address - Zip Code:35096
Practice Address - Country:US
Practice Address - Phone:256-473-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-07-3713103K00000X
AL2017-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty