Individual
FAUSTO H MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
825 EUCLID AVENUE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 474-4914
Mailing address
10408 GARNETT ST, OVERLAND PARK, KS 66214-2655
(816) 474-4920
(816) 474-4914
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00323
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00323
PH.D.
MO
01
—
C16A346
MEDICARE B WHEATLANDS
MO
Enumeration date
07/31/2006
Last updated
01/23/2008
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