Provider Demographics
NPI:1982180485
Name:UEBELE, PAIGE ASHLEY MARKHAM
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ASHLEY MARKHAM
Last Name:UEBELE
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 1:3464 N COUNTY ROAD 426
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:FL
Mailing Address - Zip Code:32732-9763
Mailing Address - Country:US
Mailing Address - Phone:352-804-9963
Mailing Address - Fax:
Practice Address - Street 1:3464 N COUNTY ROAD 426
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:FL
Practice Address - Zip Code:32732-9763
Practice Address - Country:US
Practice Address - Phone:352-804-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4014101YM0800X, 106H00000X
133NN1002X, 171400000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty