| Doctor Name: | MS. LANE ELIZABETH MCCLELLAN |
| NPI Number: | 1013146927 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | |
| Business Practice Address: | 2434 S Eason Blvd Tupelo, MS - 388046942 |
| Business Phone Number: | 6628441717 |
| Business Fax Number: | 6626805129 |
| Mailing Address: | 2210 Quail Creek Rd, TUPELO |
| State: | MS |
| Postal Code: | 388017251 |
| Phone Number: | 6628440999 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2009 |
| NPI Last Update Date: | 07/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |