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General NPI Number Information
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NPI Number | 1053832428
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Entity Type | Individual
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Provider Name | PAULA ROARK BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 9426 PFLUMM RD
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City | LENEXA
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State | KS
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Zip | 66215-3308
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Country | US
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Telephone | 913-608-7005
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Fax | 866-308-0972
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Provider Business Mailing Address
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Address Line | 9426 PFLUMM RD
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City | LENEXA
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State | KS
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Zip | 66215-3308
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Country | US
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Telephone | 913-608-7005
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Fax | 866-308-0972
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-17-36410
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA-00405
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License Number State | KS
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