Provider Demographics
NPI:1285833749
Name:MACE, ELIZABETH SUTTON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SUTTON
Last Name:MACE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SILVERSIDE RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1374
Mailing Address - Country:US
Mailing Address - Phone:302-293-4920
Mailing Address - Fax:
Practice Address - Street 1:501 SILVERSIDE RD
Practice Address - Street 2:SUITE 145
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1374
Practice Address - Country:US
Practice Address - Phone:302-293-4920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB10000618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical