Provider Demographics
NPI:1699916387
Name:HUBKA, MARLA J
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:J
Last Name:HUBKA
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 1:537 6TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2021
Mailing Address - Country:US
Mailing Address - Phone:928-777-3280
Mailing Address - Fax:
Practice Address - Street 1:4032 CROSS FOUR AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-7408
Practice Address - Country:US
Practice Address - Phone:928-279-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor