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FREDERICK A ULAM PHD, LP

Behavioral Health & Social Service Providers Clinical Neuropsychologist

Provider NPI: 1356424972

Provider Information:
 FREDERICK A ULAM PHD, LP
Gender: M
Not Sole Proprietor

Practice Location:
1350 E BRADFORD PKWY  SPRINGFIELD, MO 65804-4376 US
Tel: 417-761-5850  Fax: --

Business Mailing Address:
1300 E BRADFORD PKWY  SPRINGFIELD, MO 65804-4264 US
Tel: 417-761-5000  Fax: 417-761-5065

NPI Information:
NPI: 1356424972
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MOPYR0452
N103TA0700XBehavioral Health & Social Service Providers
Psychologist
MOPYR0452
N103TB0200XBehavioral Health & Social Service Providers
Psychologist
MOPYR0452
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
MOR0452
N103TR0400XBehavioral Health & Social Service Providers
Psychologist
MOPYR0452
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
MOPYR0452

Other Provider Identifiers:

IssuerNumberStateType
RAILROAD MEDICAREP00174113MO01
495011611MO05



American Medical Association 2012 taxonomy code information

Code: 103TC0700X

Type:

Classification:



Definition:



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