Healthcare Provider Details

I. General information

NPI: 1427976752
Provider Name (Legal Business Name): ADRIANA WEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W WALNUT ST
SPRINGFIELD MO
65806-1640
US

IV. Provider business mailing address

1400 W WALNUT ST
SPRINGFIELD MO
65806-1640
US

V. Phone/Fax

Practice location:
  • Phone: 417-818-5784
  • Fax: 417-818-5784
Mailing address:
  • Phone: 417-818-5784
  • Fax: 417-818-5784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-543513
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: