Provider Demographics
NPI:1841789344
Name:WEBER, FELICIA ANN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:ANN
Last Name:WEBER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:FELICIA
Other - Middle Name:ANN
Other - Last Name:MCGUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5220 6TH STREET FRONTAGE RD E STE 1700
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-5771
Mailing Address - Country:US
Mailing Address - Phone:217-306-6751
Mailing Address - Fax:217-670-1860
Practice Address - Street 1:5220 6TH STREET FRONTAGE RD E STE 1700
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-5771
Practice Address - Country:US
Practice Address - Phone:217-306-6751
Practice Address - Fax:217-670-1860
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-23-69677103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst