Basic Information
| Provider Information | |||||||||
| NPI: | 1558864504 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLOUD | ||||||||
| FirstName: | CAITLYN | ||||||||
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| Credential: | CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7221 GREEN MEADOW LN | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731323977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054163332 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2801 NW 61ST ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731127007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058426601 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2018 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | CF4894 | OK | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.