Provider Demographics
NPI:1518201276
Name:SHOCK, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SHOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 PETERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PEACH BOTTOM
Mailing Address - State:PA
Mailing Address - Zip Code:17563-9664
Mailing Address - Country:US
Mailing Address - Phone:443-398-0485
Mailing Address - Fax:
Practice Address - Street 1:375 PETERS CREEK RD
Practice Address - Street 2:
Practice Address - City:PEACH BOTTOM
Practice Address - State:PA
Practice Address - Zip Code:17563-9664
Practice Address - Country:US
Practice Address - Phone:443-398-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst