Provider Demographics
NPI:1215133756
Name:LOWREY PACK, CARYN (LADC)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:LOWREY PACK
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10311 E 95TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-6999
Mailing Address - Country:US
Mailing Address - Phone:918-376-6199
Mailing Address - Fax:
Practice Address - Street 1:2725 E SKELLY DR
Practice Address - Street 2:SUITE #200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6241
Practice Address - Country:US
Practice Address - Phone:918-592-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)