Provider Demographics
NPI:1144345257
Name:MARBURY, DAPHNE ALETA (LLPC)
Entity type:Individual
Prefix:MISS
First Name:DAPHNE
Middle Name:ALETA
Last Name:MARBURY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7427 GUTHRIE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-1036
Mailing Address - Country:US
Mailing Address - Phone:313-891-0641
Mailing Address - Fax:313-891-0820
Practice Address - Street 1:6861 E NEVADA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-2968
Practice Address - Country:US
Practice Address - Phone:313-891-0641
Practice Address - Fax:313-891-0820
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006827101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health