MEDICARE: MARGARET SHOCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1518201276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET SHOCK

Provider Business Mailing Address
First Line	:	375 PETERS CREEK RD
Second Line	:
City	:	PEACH BOTTOM
State	:	PA
Zip	:	17563-9664
Country	:	US
Telephone Number	:	443-398-0485
Fax Number	:

Provider Business Practice Location Address
First Line	:	375 PETERS CREEK RD
Second Line	:
City	:	PEACH BOTTOM
State	:	PA
Zip	:	17563-9664
Country	:	US
Telephone Number	:	443-398-0485
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2012
Last Update Date	:	11/19/2012

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Directions to “ MARGARET SHOCK ” Practice Location

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