MEDICARE: MS. JA'NAE DE'BORAH WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1538039938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JA'NAE DE'BORAH WILLIAMS

Provider Business Mailing Address
First Line	:	12002 LARIMORE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63138-3122
Country	:	US
Telephone Number	:	314-814-1375
Fax Number	:	314-814-1375

Provider Business Practice Location Address
First Line	:	9734 OLIVE BLVD
Second Line	:
City	:	ST. LOUIS
State	:	MO
Zip	:	63132
Country	:	US
Telephone Number	:	314-932-2402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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Directions to “ MS. JA'NAE DE'BORAH WILLIAMS ” Practice Location

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