Provider Demographics
NPI:1073678249
Name:LANEY, ELIZABETH ROBERTSON (AUD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ROBERTSON
Last Name:LANEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:KATHERINE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1742 CHERYL ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-7218
Mailing Address - Country:US
Mailing Address - Phone:662-627-5247
Mailing Address - Fax:
Practice Address - Street 1:1742 CHERYL ST
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-7218
Practice Address - Country:US
Practice Address - Phone:662-627-5247
Practice Address - Fax:662-627-1739
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA3198231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist