Provider Demographics
NPI:1073848545
Name:CLOUD, AIMEE MICHELLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:MICHELLE
Last Name:CLOUD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 SEA BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8255
Mailing Address - Country:US
Mailing Address - Phone:501-327-8614
Mailing Address - Fax:
Practice Address - Street 1:1230 SEA BREEZE DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8255
Practice Address - Country:US
Practice Address - Phone:501-327-8614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1286235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist