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General NPI Number Information
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NPI Number | 1659997443
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Entity Type | Individual
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Provider Name | KARAH SELENE PACK
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Gender | Female
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 8951 COLLIN MCKINNEY PKWY STE 402
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City | MCKINNEY
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State | TX
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Zip | 75070-8480
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Country | US
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Telephone | 469-300-0345
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 ELDORADO PKWY STE 150338
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City | FRISCO
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State | TX
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Zip | 75033-8695
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Country | US
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Telephone | 469-300-0345
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Fax |
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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 |
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License Number State |
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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 | 5759
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License Number State | TX
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