Provider Demographics
NPI:1679816029
Name:BORDERS, PATRICE ANTOINETTE NEAL (LMSW)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:ANTOINETTE NEAL
Last Name:BORDERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 W PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67217-2662
Mailing Address - Country:US
Mailing Address - Phone:316-524-7286
Mailing Address - Fax:316-524-7283
Practice Address - Street 1:1907 S HYDRAULIC ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4557
Practice Address - Country:US
Practice Address - Phone:316-524-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7709104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker