Individual
DR. SHELLEY RENEE UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
6405 OLD MAIN HILL, LOGAN, UT 84322-2057
(435) 797-0576
Mailing address
288 E 1530 N, NORTH LOGAN, UT 84341-7521
(704) 699-1231
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
12149595-2501
UT
Other
Enumeration date
05/23/2019
Last updated
07/19/2021
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