Individual
JESSICA K. PACK
Active
Individual
JESSICA K. PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHA, MS, LGC
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74000172A
GENETIC COUNSELING LICENSE
IN
01
—
96
GENETIC COUNSELING LICENSE
NE
Enumeration date
09/23/2011
Last updated
04/24/2018
Update your record
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