Provider Demographics
NPI:1104795038
Name:BORDEN, CHRISTAL C
Entity type:Individual
Prefix:
First Name:CHRISTAL
Middle Name:C
Last Name:BORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 HERIFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1942
Mailing Address - Country:US
Mailing Address - Phone:573-639-1094
Mailing Address - Fax:
Practice Address - Street 1:1804 HERIFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1942
Practice Address - Country:US
Practice Address - Phone:573-639-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor