Individual
FREDERICK WARREN UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
635 S MAPLE RD # 2, ANN ARBOR, MI 48103
(734) 238-3034
Mailing address
635 S MAPLE RD # 2, ANN ARBOR, MI 48103-3838
(734) 368-9691
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301017268
MI
103TC0700X
Clinical Psychologist
Primary
6301017920
MI
390200000X
Student in an Organized Health Care Education/Training Program
6301015567
MI
Other
Enumeration date
07/29/2016
Last updated
10/08/2019
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