Organization
MINDFUL PEACE TRAUMA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA JEAN MCENTIRE UPHOLD LCSW (OWNER/THERAPIST)
(316) 305-6064
Entity
Organization
Contact information
Practice address
8703 W 151ST ST S, SAPULPA, OK 74066-1043
(316) 305-6064
Mailing address
8703 W 151ST ST S, SAPULPA, OK 74066-1043
(316) 305-6064
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5705
OK
Other
Enumeration date
03/12/2018
Last updated
10/03/2025
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