Provider Demographics
NPI:1891959433
Name:SHERRY BUNCH, INC
Entity Type:Organization
Organization Name:SHERRY BUNCH, INC
Other - Org Name:FROM THE BEGINNING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-994-3103
Mailing Address - Street 1:120 NIX RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9017
Mailing Address - Country:US
Mailing Address - Phone:870-994-3103
Mailing Address - Fax:
Practice Address - Street 1:120 NIX RIDGE RD
Practice Address - Street 2:
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9017
Practice Address - Country:US
Practice Address - Phone:870-994-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR150776742Medicaid