=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386577757
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JALA SANAA WEBSTER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2026
-----------------------------------------------------
Last Update Date | 06/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3701 W BETHEL AVE
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47304-5467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-282-8222
-----------------------------------------------------
Fax | 765-282-8222
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1410 W WHITE RIVER BLVD APT 14
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47303-4972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------