Provider Demographics
NPI:1215771647
Name:WEBBER, ALEIGHSHA MARIE
Entity type:Individual
Prefix:
First Name:ALEIGHSHA
Middle Name:MARIE
Last Name:WEBBER
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 1:2018 LEWIS TURNER BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1352
Mailing Address - Country:US
Mailing Address - Phone:703-887-2472
Mailing Address - Fax:
Practice Address - Street 1:2018 LEWIS TURNER BLVD STE C
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1352
Practice Address - Country:US
Practice Address - Phone:703-887-2472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health