MEDICARE: MARBURY & ASSOCIATES LLC

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
1	171W00000X	Contractor
2	251S00000X	Community/Behavioral Health Agency	E0500062-SUPV	OH

General Provider Information

NPI Number	:	1760711535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARBURY & ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	5589 DUNHAM RD STE 107
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-3657
Country	:	US
Telephone Number	:	216-371-3420
Fax Number	:	216-371-3430

Provider Business Practice Location Address
First Line	:	5589 DUNHAM RD STE 107
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-3657
Country	:	US
Telephone Number	:	216-371-3420
Fax Number	:	216-371-3430

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JA'NITTA MARBURY
Credential	:	PH.D., PCC-S
Telephone Number	:	216-371-3420

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	08/04/2023

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