Individual
DR. AQUALUS MONDRELL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1320 NE WINDSOR DR, LEES SUMMIT, MO 64086-8477
(816) 287-8959
Mailing address
702 NE WESTWIND DR, LEES SUMMIT, MO 64086-5620
(512) 923-5328
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2020017925
MO
103TC1900X
Counseling Psychologist
2020017925
MO
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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