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Individual

TERRA UPHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCP

Contact information

Practice address
423 HOUSTON ST, MANHATTAN, KS 66502
(785) 587-4344
(785) 587-4377
Mailing address
PO BOX 747, MANHATTAN, KS 66505-0747
(785) 587-4300

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1459
KS
101YP2500X
Professional Counselor
2464
KS

Other

Enumeration date
06/25/2013
Last updated
08/30/2018
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