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General NPI Number Information
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NPI Number | 1205727740
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Entity Type | Individual
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Provider Name | DESIREE KARA KOETTEL LAC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2025
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 802 N 2ND ST
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City | CABOT
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State | AR
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Zip | 72023-2548
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Country | US
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Telephone | 501-232-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 819 SKYLINE DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-9235
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Country | US
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Telephone | 501-941-8824
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A2507013
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License Number State | AR
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