Individual
ELIZA LEE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
15480 ELK RIDGE LN, CHESTERFIELD, MO 63017-5313
(801) 683-9068
Mailing address
1734 CLARKSON RD # 1122, CHESTERFIELD, MO 63017-4976
(801) 683-9068
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2022012232
MO
103TH0004X
Health Psychologist
2022012232
MO
Other
Enumeration date
03/09/2019
Last updated
09/21/2022
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