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Individual

DR. KELLY BEAKLEY LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
111 N WEST ST STE H, EASTON, MD 21601-2760
(410) 443-5527
Mailing address
111 N WEST ST STE H, EASTON, MD 21601-2760
(410) 443-5527

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
05234
MD
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
05234
MD

Other

Enumeration date
10/19/2012
Last updated
07/21/2022
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