Provider Demographics
NPI:1942645676
Name:MCCLAM, DANA (MA)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:MCCLAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 E NATIONAL CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-3445
Mailing Address - Country:US
Mailing Address - Phone:843-292-1027
Mailing Address - Fax:843-292-1030
Practice Address - Street 1:1806 E NATIONAL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-3445
Practice Address - Country:US
Practice Address - Phone:843-292-1027
Practice Address - Fax:843-292-1030
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor