Provider Demographics
NPI:1851525604
Name:MAGLEBY, JOSHUA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:MAGLEBY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 W MARKET ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3336
Mailing Address - Country:US
Mailing Address - Phone:330-873-9516
Mailing Address - Fax:330-864-8678
Practice Address - Street 1:3094 W MARKET ST STE 220
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3624
Practice Address - Country:US
Practice Address - Phone:330-703-6316
Practice Address - Fax:216-696-5768
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6499103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist