MEDICARE: CARA JEANNE MARBURY

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	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1861902801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA JEANNE MARBURY

Provider Business Mailing Address
First Line	:	3422 EPIC GATE
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-3211
Country	:	US
Telephone Number	:	240-793-2267
Fax Number	:

Provider Business Practice Location Address
First Line	:	3422 EPIC GATE
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-3211
Country	:	US
Telephone Number	:	240-793-2267
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	10/04/2017

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Directions to “ CARA JEANNE MARBURY ” Practice Location

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