Provider Demographics
NPI:1164663761
Name:GRAHAM, AIMEE ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:ELIZABETH
Last Name:GRAHAM
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 1:1305 EVENING SHADE DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-8012
Mailing Address - Country:US
Mailing Address - Phone:501-213-9246
Mailing Address - Fax:501-847-5662
Practice Address - Street 1:1305 EVENING SHADE DR
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-8012
Practice Address - Country:US
Practice Address - Phone:501-213-9246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist