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General NPI Number Information
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NPI Number | 1588427181
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Entity Type | Individual
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Provider Name | JANET B BORDENAVE LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 106 FOUR SEASONS SHOPPING CTR STE 103B
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3157
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Country | US
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Telephone | 386-334-6739
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Fax |
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Provider Business Mailing Address
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Address Line | 15624 QUAIL MEADOWS DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-1748
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Country | US
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Telephone | 386-334-6739
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Fax | 386-334-6739
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2022031259
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3198
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License Number State | FL
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