Healthcare Provider Details

I. General information

NPI: 1184553414
Provider Name (Legal Business Name): ASHLEY STURDEFANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 BRADLEY DR
MOUNTAIN HOME AR
72653-2730
US

IV. Provider business mailing address

548 HIGHWAY 62 E APT 101
MOUNTAIN HOME AR
72653-3261
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-4021
  • Fax: 870-424-4112
Mailing address:
  • Phone: 870-405-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: