Provider Demographics
NPI:1225846876
Name:WEBSTER, EILEEN RENAE (BCBA)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:RENAE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 SILVERHEEL ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-5316
Mailing Address - Country:US
Mailing Address - Phone:913-405-4550
Mailing Address - Fax:913-273-2452
Practice Address - Street 1:6910 SILVERHEEL ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-5316
Practice Address - Country:US
Practice Address - Phone:913-405-4550
Practice Address - Fax:913-273-2452
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLBA00782103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst