Healthcare Provider Details

I. General information

NPI: 1841002888
Provider Name (Legal Business Name): ERICA RUTH OSTENDORF BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 W SOUTHERN HILLS BLVD STE 300
ROGERS AR
72758-8265
US

IV. Provider business mailing address

1625 N WHISTLING STRAITS AVE APT 306
FAYETTEVILLE AR
72704-6271
US

V. Phone/Fax

Practice location:
  • Phone: 479-278-7155
  • Fax: 479-278-7155
Mailing address:
  • Phone: 479-586-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82319
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: