Provider Demographics
NPI:1790046480
Name:WEBSTER, KERRIANNE COURTNEY (MS, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:KERRIANNE
Middle Name:COURTNEY
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 ABLE CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3100
Mailing Address - Country:US
Mailing Address - Phone:251-410-0160
Mailing Address - Fax:
Practice Address - Street 1:5465 ABLE CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3100
Practice Address - Country:US
Practice Address - Phone:251-644-5938
Practice Address - Fax:334-283-2350
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2017-018103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-14-15066OtherBEHAVIOR ANALYST CERTIFICATION BOARD
14074198OtherCAQH
AL2017-018OtherALABAMA BEHAVIOR ANALYST LICENSURE BOARD