Healthcare Provider Details

I. General information

NPI: 1144473430
Provider Name (Legal Business Name): GOLDIE KAROL OTWELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 12/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CENTRAL AVE SUITE 427
HOT SPRINGS NATIONAL PARK AR
71901-5318
US

IV. Provider business mailing address

835 CENTRAL AVE SUITE 427
HOT SPRINGS AR
71901-5318
US

V. Phone/Fax

Practice location:
  • Phone: 501-626-6595
  • Fax: 501-620-4546
Mailing address:
  • Phone: 501-626-6595
  • Fax: 501-620-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1008058
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: