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General NPI Number Information
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NPI Number | 1841002888
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Entity Type | Individual
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Provider Name | ERICA RUTH OSTENDORF BCABA
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 8 WILSON FARM RD STE F
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City | GREENBRIER
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State | AR
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Zip | 72058-8200
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Country | US
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Telephone | 501-733-9144
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 N WHISTLING STRAITS AVE APT 306
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6271
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Country | US
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Telephone | 479-586-9450
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-25-15792
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License Number State | AR
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