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General NPI Number Information
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NPI Number | 1083850887
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Entity Type | Individual
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Provider Name | SHERI HOMISHAK O.D., BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 410 N ARKANSAS AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-4107
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Country | US
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Telephone | 501-762-9027
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Fax |
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Provider Business Mailing Address
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Address Line | 267 TARTAGLIA AVE
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City | SPRINGDALE
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State | AR
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Zip | 72762-3071
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Country | US
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Telephone | 501-762-9027
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-08-4379
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2239
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-08-4379
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License Number State | AR
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