Provider Demographics
NPI:1629255260
Name:SHOKEK, TALI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TALI
Middle Name:
Last Name:SHOKEK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ALLEGHENY AVE
Mailing Address - Street 2:SUITE 1202
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3909
Mailing Address - Country:US
Mailing Address - Phone:202-308-3668
Mailing Address - Fax:410-825-2979
Practice Address - Street 1:28 ALLEGHENY AVE
Practice Address - Street 2:SUITE 1202
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-3909
Practice Address - Country:US
Practice Address - Phone:202-308-3668
Practice Address - Fax:410-825-2979
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical