| Doctor Name: | MS. AMY CLOUDT |
| NPI Number: | 1003278599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC I |
| License Number: | 14-09-02 |
| Business Practice Address: | 510 Nw 4th St Grants Pass, OR - 975262078 |
| Business Phone Number: | 5414745187 |
| Business Fax Number: | 5414745172 |
| Mailing Address: | 338 Sw K St, GRANTS PASS |
| State: | OR |
| Postal Code: | 975262843 |
| Phone Number: | 5415193082 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2016 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 14-09-02 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |