Provider Demographics
NPI:1497288534
Name:MCELROY, LANA
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:
Last Name:MCELROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7309
Mailing Address - Country:US
Mailing Address - Phone:580-612-8255
Mailing Address - Fax:580-286-5952
Practice Address - Street 1:202 CANTERBURY LN
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7309
Practice Address - Country:US
Practice Address - Phone:580-612-8255
Practice Address - Fax:580-286-5952
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist