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NPI Code Detail

MEDICARE: EMILY JO MARBACH

MEDICARE: EMILY JO MARBACH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianND

General Provider Information

NPI Number : 1679431787
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JO MARBACH
Provider Business Mailing Address
First Line : 2200 20TH ST SW
Second Line :
City : JAMESTOWN
State : ND
Zip : 58401-7500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4152 30TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58104-8524
Country : US
Telephone Number : 701-364-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/19/2026

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Directions to “ EMILY JO MARBACH ” Practice Location

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