Individual
BRENDA MCENTIRE UPHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8703 W 151ST ST S, SAPULPA, OK 74066-1043
(316) 305-6064
(855) 551-4090
Mailing address
8703 W 151ST ST S, SAPULPA, OK 74066-1043
(316) 305-6064
(855) 551-4090
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5705
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200531130A
—
OK
Enumeration date
08/21/2013
Last updated
10/03/2025
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