Provider Demographics
NPI:1790497923
Name:SHOUKRY, EMAN
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:
Last Name:SHOUKRY
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 1:103 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9587
Mailing Address - Country:US
Mailing Address - Phone:980-329-2107
Mailing Address - Fax:
Practice Address - Street 1:420 COPPERFIELD BLVD NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2404
Practice Address - Country:US
Practice Address - Phone:704-706-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician