Provider Demographics
NPI:1215394242
Name:UBILES, MARTA
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:UBILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 W WALNUT ST REAR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-5424
Mailing Address - Country:US
Mailing Address - Phone:610-351-2292
Mailing Address - Fax:610-351-2293
Practice Address - Street 1:462 W WALNUT ST REAR
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-5424
Practice Address - Country:US
Practice Address - Phone:610-351-2292
Practice Address - Fax:610-351-2293
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QM0801X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health