Provider Demographics
NPI:1720965874
Name:WEBB, IMANI ME'SHEL
Entity type:Individual
Prefix:
First Name:IMANI
Middle Name:ME'SHEL
Last Name:WEBB
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 1:159 MCCULLOUGH MCLIN RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-7924
Mailing Address - Country:US
Mailing Address - Phone:719-229-7239
Mailing Address - Fax:
Practice Address - Street 1:159 MCCULLOUGH MCLIN RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-7924
Practice Address - Country:US
Practice Address - Phone:719-229-7239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician