Provider Demographics
NPI:1730786013
Name:UBL, MALIKO (MSW)
Entity type:Individual
Prefix:
First Name:MALIKO
Middle Name:
Last Name:UBL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 GEIST ROAD STE E #488
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709
Mailing Address - Country:US
Mailing Address - Phone:907-328-8347
Mailing Address - Fax:
Practice Address - Street 1:534 10TH AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4903
Practice Address - Country:US
Practice Address - Phone:907-451-8208
Practice Address - Fax:907-451-8207
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AK2227911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health